LIBRARY OF CONGRESS, 



Chap. Copyright No,. 

Shelf.... .^^ 




— 



'r 



UNITED STATES OF AMERICA. 



ACCIDENTS 
EMERGENCIES 
and ILLNESSES 



A MANUAL FOR REFERENCE 



ISSUED BY 



The Mutual Life Insurance Company 

l ' OF NEW YORK 

RICHARD A. McCURDY, President 



1900 

PUBLISHED BY THE COMPANY 



TWO COPIES RECEIVED. 

Library of CongPQ8% 
Office of tht 

MAR 9 - 1900 

KogUtor of Copyrights 



7?C*7 



56801 



Copyright, 1900, 

BY 

The Mutual Life Insurance Company 
of New York. 



SECOND COPY, 



Board of Trustees 

SAMUEL D. BABCOCK 

Banker — Retired. Late firm Babcock Brothers & Co., N. Y. City 

RICHARD A. McCURDY 

President of the Company, N. Y. City 

JAMES C. HOLDEN 

President National Safe Deposit Co., N. Y. City 

HERMANN C. VON POST 

Oelrichs & Co., Agents North German Lloyd S. S. Co., N. Y. City 

OLIVER HARRIMAN 

Merchant — Retired, Late firm Low, Harriman & Co., N. Y. City 

ROBERT OLYPHANT 

Ward & Olyphant, Miners and Shippers of Coal, N. Y. City 

GEORGE F. BAKER 

President First National Bank, N. Y. City 
Vice-President Central R. R. of New Jersey 

DUDLEY OLCOTT 

President Mechanics' and Farmers' Bank, Albany, N. Y. 

FREDERIC CROMWELL 

Treasurer of the Company, N. Y. City 

JULIEN*T. DAVIES 

Counsellor-at-Law. Davies, Stone & Auerbach, N. Y. City 

CHARLES R. HENDERSON 

Banker. Henderson & Co., N. Y, City 

RUFUS W. PECKHAM 

Justice U. S. Supreme Court, Washington, D. C. 

J. HOBART HERRICK 

Banker and Broker. J. H. Herrick & Co., N. Y. City 

WILLIAM P. DIXON 

Counsellor-at-Law. Miller, Peckham & Dixon, N. Y. City 

ROBERT A. GRANNISS 

Vice-President of the Company, N. Y. City 

HENRY H. ROGERS 

President National Transit Co., Standard Oil Co., N. Y. City 

JOHN W. AUCHINCLOSS 

Dry Goods Commission. Auchincloss Bros., N. Y. City 

THEODORE MORFORD 

Cashier Sussex County Nat. Eank, Newton, N.J. 



BOARD OF TRUSTEES— Continued 

WILLIAM BABCOCK 

Commission Merchant. Parrott & Co., San Francisco, Cal. 

STUYVESANT FISH 

President Illinois Central R. R. Co., N. Y. City and Chicago 

AUGUSTUS D. JUILLIARD 

Dry Goods Commission. A. D. Juilliard & Co., N. Y. City 

CHARLES E. MILLER 

Counsellor-at-Law. Miller & Wells, N. Y. City 

WALTER R. GILLETTE, M. D. 

General Manager of the Company, N. Y. City 

H. WALTER WEBB 

3d Vice-President N. Y. C. & H. R. R. R., N. Y. City 
GEORGE G. HAVEN 

Vice-President National Union Bank, N. Y. City 

GEORGE S. BOWDOIN 

Banker, Retired. Late J. P. Morgan & Co., N. Y. City 

ADRIAN ISELIN, Jr. 

Vice-President Guaranty Trust Co. of N. Y. 
Banker. Adrian Iselin & Co., N. Y. City 

WILLIAM C. WHITNEY 

Ex-Secretary of the Navy, N. Y. City 

WILLIAM ROCKEFELLER 

Standard Oil Co., N. Y. City 

JAMES N. JARVIE 

Arbuckle Bros., Coffee, N. Y. City 

CHARLES D. DICKEY, Jr. 

Banker. Brown Bros. & Co., N. Y. City 

ELBRIDGE T. GERRY 

Counsellor-at-Law. 261 Broadway, N. Y. City 

A. N. WATERHOUSE 

Life Insurance. Lambert & Waterhouse, Philadelphia, Pa. 

WILLIAM J. SEWELL 

United States Senator. Camden, N. J. 

JAMES SPEYER 

Banker. Speyer & Co., New York 
CHARLES LANIER 

Banker. Winslow, Lanier & Co., N. Y. 



PREPUCE. 

This book has been prepared and published in the 
hope that it will be of service in alleviating suffering 
and saving life by the timely application of the advice 
and instruction contained in its pages. In some 
respects it is a revised edition of two pamphlets form- 
erly published by The Mutual Life Insurance Com- 
pany of New York, entitled "Plain Directions for 
Accidents, Emergencies and Poisons " and " Plain 
Directions for the Care of the Sick." These little 
volumes were printed originally in 1875, and several 
large editions have since been gratuitously distributed. 
It has been deemed advisable to re-write them and em- 
body in the new production such additional changes 
in the matter as the advance in medical science dur- 
ing the past twenty-five years rendered necessary in 
order to make the teachings of the book conform to 
present practices. The book has been written and 
revised by competent physicians for gratuitous dis- 
tribution and is intended to indicate what should be 
done in cases of ordinary accidents and illnesses 
prior to the coming of the skilled assistance to be fur- 
nished by the trained nurse and the medical adviser. 
If what is hereinafter written shall in any way tend to 
prevent unnecessary suffering or contribute to save 
the life and activity of some member of the commu- 
nity, the company will feel amply rewarded for the 
trouble and expense involved in the preparation and 
publication of this book. 



( ■ 



CONTENTS 



PAGE. 

SECTION I. ACCIDENTS 5 

II. EMERGENCIES 51 

III. POISONS 79 

IV. CARE OF INVALIDS .... 115 
V. REMEDIES ....... 157 

INDEX . 167 



SECTION I. 



ACCIDENTS. 



A policy in The Mutual Life Insurance 
Company of New York may not prevent an 
accident, but it will materially aid in recovery. 



INTRODUCTION. 

Scarcely a month passes by that we do not meet 
somewhere an accident or an emergency in which a 
little reliable information would be of the greatest 
service. One of the difficulties usually to be contended 
with in such cases is a lack of knowledge on the part 
of the bystanders as to what should be done. It will 
be found, as a rule, that the simplest and usually the 
most useful things are neglected, while there is a dis- 
position to rely upon cumbrous appliances, which are 
often disadvantageous, and sometimes positively hurt- 
ful. 

The object of this pamphlet is to present in a 
compressed form, for easy recollection and ready 
reference, a few suggestions as to what should 
be done in certain cases of emergency before the arri- 
val of skilled professional assistance. It is, perhaps, not 
too much to say that what can be done to give relief 
or save life must in many cases be done by some one 
before the aid of a physician can be procured. It 
has been truly said, "for want of timely care, millions 
have died of medicable wounds." 

As far as possible, the use of technical terms will be 
omitted, although where necessary they will be used, 
with a brief definition inclosed in brackets ; but the 
writer would respectfully suggest that, whenever 
possible, the scientific terms be remembered and 
used, instead of the popular expressions for the same 
thing. A scientific term, the world over, means but 
one thing; while a popular expression, in one place, 
means one thing, and in another, two or three things ; 
and possibly, nothing at all. 

{tW Insure in The Mutual Lipb Insurance Co. op New Yobk.) 



A wise precaution against accidents of all kinds 
is a life policy in The Mutual Life Insurance 
Company of New York. 



ACCIDENTS IN GENERAL. 



An accident usually assembles a crowd around the 
victim. The first thing to be done is to get the people 
away from the injured person. A space of at least ten 
feet on every side should be kept wholly free from 
everybody except the one or two who are in charge 
of the operations for relief. If others are needed to 
assist in some special duty, as lifting, removing of 
dress, etc., they can be specially selected from the 
crowd for the moment and then dismissed. The 
kindest thing a bystander can do is to insist upon a 
free space around the injured person, and to select Crowds and 
from the crowd those who will hold themselves in 
readiness to start for whatever the physician or the 
individual in charge of the case may require. To show 
how little real interest the inside layer of the crowd 
takes in the restoration of the patient, it will often 
be almost impossible to get one of them to run an 
errand in the interest of the sufferer. 

If the person has been thrown from a carriage, in- 
jured by a fall from a height, blow or other cause, 
while there may be no fracture or other external injury 
evident, the nervous system has received what is called 
a "shock." As is commonly said, the person is "faint." 

A person suffering with such symptoms should 
be placed flat on the back, with the head, neck 

(Es?* Insnr9 in Thb Mutual Lifb Insurancb Co. o» New Yoek.) 



10 



ACCIDENTS IN GENERAL. 



person. 



and shoulders slightly raised. The limbs, at the 
same time, should be straightened out, if practicable; 
so that the heart, which is already depressed in action, 
may act at as little disadvantage as possible. The 
G , cravat, collar and everything else calculated to 

treatment of impede the circulation toward the head or the 
an injured movements of the chest should be loosened or re- 
moved. If the injury is slight, reaction will soon take 
place after giving the person a sip of cold water, 
brandy (a teaspoonful in a tablespoonful of cold 
water), or aromatic spirits of ammonia (twenty drops 
in a tablespoonful of cold water) repeated in a few 
minutes. Gentle frictions to the extremities ; a few 
drops of cologne-water on a handkerchief to the 
nostrils ; if the weather is hot, the use of a palm-leaf 
fan; hot flannels to the limbs and epigastrium, (pit 
of the stomach), are all likewise useful in assisting 
reaction. 

By this time, should a surgeon have arrived, he will 
examine and decide upon the special nature of the 
injury, and inaugurate measures of special relief. 
Should he have not appeared, and it is thought best 
to remove the patient to the hospital or his home, a 
stretcher should be procured, or a substitute in 
the shape of a settee or shutter. The injured 
person should be gently slipped on it, the body 
being supported as much as possible along its 
length, and the face covered so as to prevent, as 
much as practicable, the uncomfortable feeling of 
being stared at by passers-by. Four persons of 
uniform gait should then gently lift the stretcher and 
slowly carry the person to his destination. In most 
cities, appliances for carrying injured persons are 
kept at the station-houses, and can be obtained on 



Removing 
an injured 
person. 



(£W Insure in The Mutual Life Insubance Co. op New Tobk.) 



SHOCK. 11 

application, as well as the services of a good police- 
man. The authority of the latter is almost invaluable 
in keeping away the crowd while conveying the person 
through the streets. If the person is to be taken to 
the hospital, a dispatch from a police-station will 
secure, free of charge, an ambulance with competent 
attendants to take charge of the injured individual. 

Directions for fracture and dislocations are given 
elsewhere, pp. 32-33. 

SHOCK. 

Mild forms of shock, or collapse, as it is sometimes 
called, are often, by the non-professional, confounded 
with fainting (syncope), and an ordinary attack of 
fainting is analogous to shock. The symptoms be- 
tween the two vary rather in degree and duration than 
in kind. 

Life may be destroyed by certain agencies, as a blow 
upon the "pit of the stomach," or a sudden and pow- 
erful emotion of the mind, and no visible trace be left 
in any part of the body. This is called "death from 
shock" and is the extreme result of shock. 

Usually the patient lies in a state of utter prostration. 
There is pallor of the whole surface ; the lips are blood- 
less and pale. The eyes lose their luster, and the s y m P toms - 
eyeball is usually partially covered by the drooping 
upper lid. The nostrils are usually dilated. The skin 
is covered with a cold, clammy moisture, often gath- 
ered in beads of sweat upon the forehead. The tem- 
perature is low, and perhaps the person shivers. The 
weakness of the muscles is most marked ; as the 
phrase is, "the patient is prostrated." The mind is 
bewildered, often insensible, unless aroused; and in 

( t3T Insure in The Mutual Life Ixsusascb Co. op New Tobx.) 



Shock. 



12 



SHOCK. 



Causes. 



Influence of 
age. 



many cases, nausea and vomiting are present. In 
extreme cases, the nausea and vomiting are not so apt 
to occur. 

Sudden and severe injuries, particularly if extensive 
cause shock. Burns — especially of children — ex- 
tending over a large surface, even if not to a great 
depth, are often followed by shock, and this com- 
plication requires the earliest attention. 

Certain poisons, as tobacco and tartar emetic, act 
in this manner, depressing the system. So does a 
current of electricity, as is seen in the effects of light- 
ning. 

Loss of blood produces or aggravates shock. Hence 
a slight injury, with much loss of blood, may be at- 
tended with more shock than a comparatively more 
severe injury without the loss of blood. Debility 
favors the influence of shock. A weak system is 
more easily impressed by it, and, as should be ex- 
pected, reaction from its effects is longer in taking 
place. 

As the vital powers of life decline, from engrafted 
or natural causes, there is less power available as a 
reserve to meet contingencies. In youth there is 
an available fund of this kind; in the adult the re- 
sources of the system may be equal to the task of 
ordinary maintenance, but in the aged, as said before, 
there is much less ability to deal with sudden losses 
of strength. The aged, therefore, are slow to rally 
from the effects of shock. They have more power of re- 
sistance than the young. The shock does not readily 
make an impression, as it does in the young, but 
when it does, the impression endures. In the young 
the impression is more easily made, but sooner sub- 
sides. 



(13^* Insure in The Mutual Life Insurance Co. o» New York.) 



SHOCK. 18 

Treatment. — This consists in first placing the 
patient as flat on his back as possible, with 
the head raised not over an inch. This is an 
important point in cases of ordinary fainting, and 
whenever the vital powers are depressed. Stimu- 
lants are required. The aromatic character of brandy 
enables it to be retained by the stomach when 
whisky and other forms of alcohol are rejected. A 
teaspoonful on cracked ice every minute, until six or 
eight have been taken, is the best way to give it. If 
the temperature of the body is raised by it, and there 
seems a revival of the action of the heart, enough 
brandy has been given. Twenty drops of the aromatic 
spirits of ammonia in a teaspoonful of water may be 
given every couple of minutes, until four or five doses 
have been taken. Applications of heat to the extremi- Treatment 
ties and "pit of the stomach" are very useful. Flan- of shock - 
nels wrung out in hot water, or bottles of hot water 
properly wrapped up, should not be neglected. Mus- 
tard-plasters are often used, but they are so inferior to 
heat for the purpose, if that can be applied, and so apt 
to blister, thereby making it impossible to use anything 
else on the surface, that some reluctance is felt in ad- 
vising them. 

Nausea and vomiting are often present in shock, 
and can best be allayed by getting the patient to 
swallow small chips of ice whole. Ice can be easily 
chipped by standing the piece with the grain up- 
right, and splitting off a thin edge with the point of 
a pin. 

Ammonia (smelling salts), applied to the nostrils, is 
often useful ; and cologne, on a handkerchief, is fre- 
quently pungent enough to be of service in the same 
way. 



(Cy Insure in Th« JIutcal Lifb Ixsurakce Co. os> New York.) 



14 



FAINTING— ASPHYXIA. 



Treatment 
of fainting. 



FAINTING. 

The head of the party who has fainted should be 
kept lower than the rest of the body. Should the 
person be sitting in a chair at the moment, stand be- 
hind the chair, reach the hands over in front, so as 
to grasp the sides of the chair, take a step backward, 
and then slowly depress the back, the head being sup- 
ported until the floor is reached. An assistant by 
holding the knees will prevent lateral slipping off from 
the seat of the chair. It is so rapidly and easily done, 
besides so effective in its operation, that little else re- 
mains to be done. Usually the back of the head of 
the patient scarcely reaches the floor before conscious- 
ness returns. 



ASPHYXIA. 



Meaning of 
asphyxia. 



This commonly used word signifies an absence of 
pulse. It states a condition, but not the cause, and 
indicates suspended animation, produced by the non- 
conversion of the venous blood in the lungs into 
arterial. The supply of good air to the lungs being 
cut off by some cause, the necessary purification at 
that point no longer takes place, and death of the 
entire body ensues from the absence of arterial blood, 
or the presence of venous blood ; some physiologists 
regard it as due to the one cause, and some to the 
other. In other words, the person dies because the 
blood is not purified. 

There are several varieties of asphyxia: (i) As- 
phyxia from submersion, as in the ordinary drowning 
in water or other fluids ; (2) asphyxia from mechanical 
causes, as by strangulation, or hanging, and by for- 

(I2P* Insure in The Mutual Lip* Insueanob Co. op Nbw York.)} 



ASPHYXIA — DROWNING. 15 

eign bodies in the windpipe or its approaches ; (3) as- 
phyxia by inhalation of gases, known as suffocation; 
(4) asphyxia from torpor of the medulla oblongata Varieties of 
(an important portion of the brain, at the junction of as P h y xia - 
the spinal cord and what is called the brain), produced 
by the introduction into the blood of certain poisons. 



DROWNING. 

As said above, this is asphyxia from submersion in 
water or other fluids. This accident is of such fre- , sp y . xla y 

drowning. 

quent occurrence that it is the duty of every member 

of the community to understand the measures of 

prompt relief in such cases. 

The body should be recovered as soon as possible 

from the water. Then turn the face and head down- ^ 

1 r 1 1 m , • , Treatment, 

ward for a moment and, while so doing, thrust a 

finger far backward into the mouth and depress the 

tongue forward. This favors the escape of a small 

quantity of water or mucus, or other substances, often 

collected at the base of the tongue, which tends to clear the 

obstruct the entrance of air to the lungs. The bar- mouth and 

barous practice of rolling the person over a barrel, or throat. 

hanging him head downward, to permit the escape 

of water from the lungs, has almost ceased, in view 

of the fact, now generally known, that no water gets 

into the lungs. 

If it is possible to get blankets or some other dry 

coverings, the body should be rapidly stripped of its 

clothing and placed in them. The extremities should Make hot 

be rubbed with the dry hands, and heated flannels ap- applications. 

plied to the rest of the body, which should lie almost 

flat. If these things can be done in a house nearby, 

(fir Insure in The Mutual Life Insurance Co. op New York.) 



16 



DROWNING. 



Condition of 
the blood in 
asphyxia. 



Sylvester's 
Method of 
artificial 
respiration. 



Sylvester's 
Method of 
artificial 
respiration. 



so much the better ; but no time should be lost in trans- 
porting the body. 

The following is the condition of affairs: Each 
atom of the body requires arterial blood, which is 
blood purified in the lungs by exposure to the air 
breathed. The purification has been suspended, and 
to that extent the life of the body is suspended. Move- 
ments of the chest, by which air is inhaled, are at a 
standstill, and cannot, of themselves, be resumed. If 
artificial breathing can be carried out for some time, it 
will be seen that these impurities may be so far re- 
moved that natural respiration can take place. Two 
methods are usually employed for the purpose — the 
first and best known being "Sylvester's Ready 
Method." 

This consists, after the above suggestions have been 
carried out, in pulling the tongue forward in order to 
favor the passage of air along the base of the tongue 
into the trachea (windpipe), and then in drawing the 
arms away from the sides of the body and upward, 
so as to meet over the head, by means of which the 
ribs are raised (expansion of the chest), by the pectoral 
muscles running from them to the arms near the 
shoulder. A vacuum is thus created in the lungs, the 
air rushes in, and the blood is then purified by the 
passage of the impure gases in the blood-vessels to the 
air, and by the giving up by the air of a portion of its 
oxygen to the blood. The arms are now brought 
down to the sides, and the elbows made to almost 
meet over what is called the "pit of the stomach." This 
produces contraction of the walls of the chest, and 
expulsion of the impure air from the lungs. 

These two movements constitute an act of respira- 
tion, and should be persisted in, without interruption, 

( K29" Insure in The Mutual Life Insurance Co. ok New York.) 



DROWNING. 



17 



at the rate of about sixteen to the minute. In other F requencyo f 

words, each complete movement should occupy about respiratory 

four seconds, which is about the natural rate of respira- acts, 
tion in health. 




It is sometimes quite difficult to keep the tongue 
from slipping backward, and when it does so, it tends 
to prevent the air from rushing into the windpipe. It 
is a good plan to draw it foward by holding its tip 
with a handkerchief or dry cloth. If it is too slip- 
pery it may be necessary to pass a hatpin or a hairpin Keep the 
or a needle with a coarse thread right through the tongue for- 
tongue. The tongue should be gently drawn forward ward - 
with each inspiratory act and allowed to slip back 
gently with each expiratory act. 

The second "Ready Method," as it is called, is that 
of Marshall Hall : 

The person whose breathing is to be restored is 
placed flat on the face, gentle pressure is then made 
on the back, the pressure removed, the body turned 



Insure in The Mittual Life Insurance Co. op New York. 



18 



DROWNING. 



Marshall 
Hall's 
Method of 
artificial 
respiration. 



Advantage 
of previous 
practice. 



Cramps 
when swim- 
ming. 



After- 
treatment of 
drowning. 



on its side, or a little beyond that. The body is then 
turned again on the face, where gentle pressure is 
again used to the back, then turned on the side. This 
should be done about sixteen times in a minute. 

Both of these methods have the same object in view ; 
either may be exclusively used, or one may be al- 
ternated with the other. Most physicians express a 
preference for the first described ("Ready Method of 
Sylvester.") Both of these procedures should be prac- 
ticed, in advance, by the reader, because such practice 
is more easilv remembered than a concise rule. There 
are few people in an ordinary life, who will not find 
it useful to have knowledge of this kind at their 
fingers' end. 

In speaking of the restoration of persons drowned, 
it is often said that they were good swimmers and 
must have been attacked with "cramps." This is a 
spasmodic contraction of the muscles beyond the 
control of the individual, and occurs after exhaustion 
of the muscles from over-exertion. Persons suffering 
from debility should never be induced to go be- 
yond their depth in the water, or out of reach of 
immediate assistance. There is no warning in ad- 
vance of the seizure, and the person sinks at once. 
Many lives are lost each season, in shallow as well as 
in deep water, from these seizures, which could have 
been avoided had the bather, perhaps just recovering 
from an attack of sickness, or even indisposition, not 
neglected the precautions mentioned. 

Recovery from asphyxia by drowning can scarce- 
ly be expected to take place after an immersion of 
five or six minutes, although there are well-authenti- 
cated cases where restoration has taken place after 
an immersion of as much as twenty minutes. The 



(t^* Insure in Thb Mutual Life Insurance Co, op New Toek.) 



DROWNING — HANGING. 19 

effort ought to be made, and persisted in until the 
arrival of a physician, or for at least a couple of hours. 
As soon as returning vitality permits, some brandy in 
a little water may be given ; and, as the strength of 
the person is usually completely exhausted by mus- ■ 
cular efforts of the most violent and continued charac- 
ter to save himself from drowning, some beef-tea or 
other easily digested nourishment should be given. 
He should be kept in bed, very quiet and comfortably 
warm for some hours at least. 

HANGING. 

Here death results from asphyxia induced by pres- 
sure applied to the trachea (windpipe) from the out- Asphyxia 
side, as in strangling, or hanging. The body, if hang- from 
ing, should be at once cut down, care being taken not an & ing - 
to let it fall. Remove by the finger, as in the 
directions in drowning, any accumulation of mucus 
at the base of the tongue, and place the body on 
the back, just as directed for a person taken from the 
water. If the body is still warm, after removal of the 
clothing, the face, head, neck and chest should be 
dashed freely with cold water. To do this success- 
fully, a person should stand six feet or more away 
with a bowl of cold water, and then throw its contents 
with as much force as possible against the person. 
This having been repeated a number of times, the 
water should be rapidly wiped off with a towel. There 
is little essential difference in the condition of a per- 
son who has been hanged and one who has been Treatment, 
drowned. In both it is asphyxia; in one case, the air 
has been kept from the lungs by a ligature ; in the other 
by a liquid. Artificial respiration in both of them 

tW Insure in Thk Mutual Life Insueanck Co. op New York.) 



20 



HANGING — SUFFOCATION 



must be used, assisted for the same reason and in the 
same manner by like auxiliaries. 

There is an impression, quite prevalent among the 
ignorant, that a penalty is incurred at law for cutting 
down the body of a person found hanging, unless the 
sanction of the coroner is obtained. Such delay is un- 
necessary and unjustifiable; and an effort should at 
once be made to restore suspended animation by the 
methods given. 



Asphyxia 

from 

suffocation, 



SUFFOCATION. 

There are several gases which, when inhaled, are 
followed by symptoms of asphyxia. The little valve 
(epiglottis) over the entrance of the trachea (wind- 
pipe) is so extremely sensitive that it will not even 
permit a drop of water to pass without a spasmodic 
closure of the opening, followed by coughing. It is 
not only sensitive to solids and liquids, but also to 
the presence of most gases. At one time it was 
thought that all gases were taken past it into the lungs, 
and thence absorbed into the blood. The prevailing 
opinion now is that most of them irritate the valve at 
the entrance of the trachea, and closure of the entrance 
follows. The breathing is thus interrupted much as 
it is in drowning, where the liquid cuts off the passage 
of air to the lungs ; or as in hanging, where the ligature 
prevents the entrance of air. In such cases death 
results from asphyxia. 



Carbonic- 
acid gas. 



CARBONIC-ACID GAS. 

Asphyxia by this gas takes place as soon as the per- 
son inhales it. A sudden sense of suffocation is felt, 
with dizziness and inability to stand. If the individual 

(Cyinsure in The Mutual Life Insurance Co. op Nrw York.) 



SUFFOCATION. 21 

is standing at the time the air is taken into the lungs, 
and falls, he is in a position while down to inhale still 
more of the carbonic-acid gas, for it is heavier than 
the air. 

This gas, sometimes known under the name of 
"choke damp," is produced in the ordinary process 
of fermentation, in burning and slacking lime; it is Where 
also found in mines, particularly coal mines, and in oun ' 
wells, cellars or caves which have long been closed. 
It is considerably heavier than the atmosphere, and 
is consequently found lying on the floor of the cavity 
where confined. 

No well, vat, old cellar, or cavern of any kind, should 
ever be entered without first lowering a lighted candle 
into the deepest point. If the flame is extinguished, 
or burns dimly, this indicates the presence of this tecte( j an( j 
gas, and no one, under any circumstances, should dislodged, 
be permitted to enter until this foul air has been re- 
moved. It lies at the bottom, because it is too heavy 
to ascend. It is not so heavy, however, but that a 
strong current of common air will dislodge it. Buckets 
of water dashed down into the well, or masses of 
lighted shavings or blazing paper, give enough 
movement to the carbonic-acid gas to dislodge it from 
its resting place. Freshly slacked lime also rapidly 
absorbs it. After testing the success of the efforts 
by again introducing the lighted candle, it can soon 
be known whether a person may enter with impunity. 

Sometimes there may be no carbonic-acid gas in 
the cavity, but the efforts of the workmen will dislodge 
it from an adjacent space into the one in which they 
are breathing. This possibility should never be lost 
sight of. 



(S3T" Insure in Thb Mutual Life Insurance Co. op New Yore.) 



22 



SUFFOCATION. 



How to re- 
move a per- 
son over- 
come by 
carbonic- 
acid gas. 



Treatment. 



When a person appears overcome by this carbonic- 
acid gas, he is, of course, wholly unable to help 
himself, and must at once be removed. Sometimes 
a grapnel-hook can be used with advantage, but 
often the better way is to rapidly lower some bold, 
clear-headed person, with a rope securely fastened 
around his middle, who can seize and bring to the sur- 
face the unfortunate individual. No time should be 
lost in descending or arising, as the person lowered 
depends upon doing everything during the interval 
that he can hold his breath; for, of course, should 
he inhale the gas, his position, in this respect, would 
be but little better than the man he attempts to suc- 
cor. A large sack is sometimes thrown over the head 
and shoulders of the person who descends. It contains 
enough air to serve for several inhalations, while the 
texture of the material prevents the admission of the 
deleterious gas in a hurtful degree. 

The person suffering from asphyxia, immediately 
after being brought out from the gas, should be 
placed on his back, the neck and throat bared, and 
any other obstacles to breathing quickly removed. His 
body should then be quickly stripped, and if he has 
not fallen into water on being overpowered by the 
gas, his head, neck and shoulders should be freely 
dashed with cold water. 

Remember, this is not "sprinkling," as commonly 
practiced, but, as said before, a person should stand 
off some distance, with a bowl of cold water, and 
throw its contents, with as much force as possible, 
against the parts. Other bowlfulls should follow with- 
out an interval for half a minute, while one can count 
thirty slowly, then the dripping water be wiped away 
by a towel. This procedure should be repeated from 



(ZS~ Insuro in The Mutual Life Insurance Co. op New York.) 



SUFFOCATION. 23 

time to time, as required. Sometimes, if a brook of 
water is near, the stripped person might be repeatedly 
dipped into it, care being taken, of course, not to dip 
his face. Artificial respiration should be used as soon 
as possible. 

If the person has fallen into water and become 
chilled, the use of the cold water, in this manner, should 
be avoided, as the evaporation of the moisture ab- 
sorbs more heat than can be manufactured by the 
exhausted and overpowered system. In such a case, 
the body of the person should be put into a warmed 
bed, with hot applications, and artificial respiration 
(p. 16) at once established, as in the asphyxia from 
drowning and hanging. 

While artificial respiration is being used, friction ap- 
plied to the limbs should be kept up. 

BURNING CHARCOAL. 

Carbonic-oxide, a very poisonous gas, is given 
off during the burning of charcoal, and when sp yxla 
inhaled for a sufficient length of time, rapidly proves bonic-oxide 
fatal. The person quickly drops insensible, and dies gas. 
of asphyxia, very similarly to one who succumbs to 
carbonic-acid gas. The treatment there advised under 
the previous heading should at once be carried out. 

ANTHRACITE AND BITUMINOUS COAL. 

These also, when burned in a close room, as a 
kitchen shut up for the night with an open stove of 
burning coals, give off, to a degree, the peculiar Asphyxia 
poisonous gas alluded to as coming from burning char- f rom burn - 
coal, carbonic-oxide gas, as well as other noxious lng coa ' 
gases. Persons sleeping in such a room, unless awak- 
ened as the air becomes fouled, will soon be found 

(C^* Insure in The Mutual Life Insurance Co. of New York.) 



24 



SUFFOCATION. 



Asphyxia 
from 
ordinary 
gas. 



Asphyxia 
from foul air 
in drains 
and privies. 



senseless or dead. The treatment should be as de- 
scribed in the preceding pages, under asphyxia from 
inhaling carbonic-acid gas. 

COMMON BURNING GAS. 

Persons retiring at night often leave the gas "turned 
down," and the flame becomes extinguished. Enough 
gas may then escape to give trouble to the sleeper un- 
less the room is well ventilated. Persons have been 
known to "blow it out" as they would a candle, and 
suffocation more or less complete has followed. 

Treat as in the asphyxia from carbonic-acid gas 
just described. 

FOUL AIR IN DRAINS AND PRIVIES. 

This usually consists of sulphuretted hydrogen, and 
arises from the decomposition of the residual matters 
found in these situations. Great caution, on this ac- 
count, should always be observed on opening and 
entering such places, or places in possible communica- 
tion with them, especially if they have been long closed. 
A small quantity of pure sulphuretted hydrogen, if in- 
haled, is usually fatal ; but, in the cases referred to, 
the gas usually exists diluted with common air. The 
breathing becomes difficult, the person loses his 
strength, falls, becomes insensible and cold, lips and 
face are blue, and the mouth is covered with bloody 
mucus. 

The person should be removed as quickly as pos- 
sible beyond the influence of the foul air, and the 
treatment under the head of "Carbonic-Acid Gas" 
pursued. 

The possibility of such a disaster should always 
be borne in mind in opening long-closed drains or 



PP" Insure in The Mutual Life Insurance Co. op Nbw York.) 



SUFFOCATION — LIGHTNING. 25 

privy-vaults, and the danger lessened by taking a few 
pounds of chloride of lime (bleaching powder), dis- 
solving it in a pailful of water, and dashing it into the 
cavity. In the absence of this, lime and water in the 
form of the common "whitewash" may be employed. 
This gas readily combines with lime, to that extent 
freeing the air of the poisonous compound. 

FOREIGN BODTES IN THE THROAT. 

A piece of food or some other body often gets back 
into the mouth, and cannot be swallowed. In such a 
case, the finger will often be able to thrust it down- Foreign 
ward, should that be thought best. A hairpin, body in the 
straightened and bent at the extremity, will often 
drag it out. If the body is firm in character, a pair 
of scissors, separated at the rivet, and one blade held 
by the point, will furnish a loop, which often can be 
made to extract it. 

ACCIDENTS FROM LIGHTNING. 

A person struck by lightning is usually rendered 
more or less unconscious, the unconsciousness struck by 
lasting for a longer or shorter time. Cases are on lightning. 
record where a person struck exhibited no sign of 
life for an hour, and then recovered. Temporary par- 
alysis of a portion of the body may remain for a while, 
or a disturbance of some special function, such as the 
sight, smell, taste, or hearing. When death takes 
place, it is from shock to the brain and nervous system. 

When the person exhibits little or no signs of life, Treatment, 
the clothing should be rapidly removed and the 
body exposed to a dashing of cold water ; then dried, 
placed in bed, and warmth applied, particularly to the 

Insure in Thk Mutual Life Insurance Co. op New York. 



26 LIGHTNING — 3URNS. 

"pit of the stomach," by means of glass or rubber 
bottles filled with hot water. 

Artificial respiration should be kept up until the 
parts of the brain and nervous system in charge of this 
duty shall have recovered enough to attend to it. As 
said before, recoveries after an hour of supposed death 
are on record. 

Some stimulant, as brandy (teaspoonful) or the 
aromatic spirits of ammonia (twenty drops in a table- 
spoonful of water), repeated in a few minutes, may be 
given. 

Burns caused by lightning should receive the same 
attention as a burn from any other cause. Some- 
times an injury observed is not directly due to the 
electricity, but to a fragment detached by that agent 
from a neighboring substance. 

BURNS AND SCALDS. 

When the clothing catches fire, throw the person 
Put the fire down on the ground, so that the flames will not 
out. rise toward the mouth and nostrils. Then with- 

out a moment's delay, roll the person on the 
carpet, or, if possible, in a hearth-rug, so as to 
stifle the flames. If no rug can be had, use your coat. 
Keep the -flame as much as possible from the face, so 
as to prevent the entrance of the hot air into the lungs. 
This can be done by beginning at the neck and 
shoulders with the wrapping. 

If the burn or scald involves considerable surface, 
symptoms of shock from the extreme of mere weak- 
ness to that of utter prostration appear. This at once 
requires prompt attention, and a few drops of aromatic 
spirits of ammonia in water, or a little brandy, should 

Eg* Insure in The Mutual Life Insurance Co. of New Yoek.) 



BURNS. 27 

be given and repeated in a few moments until a return 
of the strength is apparent. A burn, superficial as far 
as depth is concerned, but covering a large surface, Shock from 
especially in the case of small children and aged burns, 
people, is usually considered more serious than a 
burn smaller in extent, but deeper and more com- 
plete. If there is reason to suppose that hot air or 
steam has been inhaled, no time should be lost in ob- 
taining the opinion of a physician as to the result of 
the injury to the throat and lungs. 

Treatment. — The burnt surface should be cleansed 
carefully by allowing water to trickle over it. 
The skin over a blister should not be cut off, but 
should be snipped with scissors near the edge, and Treatment, 
the water gently squeezed out. This allows the skin 
to remain as a protective. If the blister re-forms it 
may be necessary to repeat this operation. 

If the burn or scald is slight in character, one of the 
best applications is the cold water dressing, p. 32, 
keeping the linens used constantly wet. 

In more severe cases a very good application is 
carron oil, which is a mixture of linseed oil and lime- 
water in equal parts. Sweet-oil alone is very good. 
Vaseline, with a little boric acid rubbed up with it, is 
also very soothing. Lard and baking soda mixed will 
relieve pain. 

Wheaten flour is often dusted over the burn ; but 
this, with the discharges, hardens, and is of as little p lour or 
comfort as an application of small crusts of bread cotton-wool 
would be to the injured part. Cotton wool (carded n °t to be 
cotton, cotton batting) is often used, but the fibers be- used ' 
come imbedded in the discharges, and then cannot be 
detached without pain and disturbance of the wound. 

Talcum powder, or Fuller's Earth, is very useful as 



(XW Insure in Thb Mutual Lipe I.vsctbanci Co. op New Yobk.) 



28 



BURNS. 



Very simple 
measures. 



If shock or 
pain is 
present. 



Scalds. 



drying powders after the blister has been cut, or 
any of the skin becomes detached. 

If the burn or scald, particularly the latter, is super- 
ficial in character, a simple and useful dressing is the 
application by brush or a soft wisp of old muslin, 
of the white of egg to the injury. As soon as the first 
layer dries, another should be used. A lather of soap 
from the shaving-cup, applied by the brush in the same 
way, is often followed by immediate relief. These 
substances protect from the action of the air the ir- 
ritated nerves beneath. 

If a physician has been sent for, it is better not to 
make any domestic applications to the burned parts. 
Such things frequently prevent him from using those 
better adapted, and keep him from forming a cor- 
rect estimate of the real extent of the injuries. 

If there is much shock and depression, stimulants 
will be needed, such as aromatic spirits of ammonia, 
brandy or whisky. If there is much pain, laudanum 
can be given, five drops every two or three hours, until 
four or five doses have been administered. 

Burns and scalds practically differ but little from 
each other. Scalds are usually more confined to the 
outer cuticle, unless the substance containing the heat 
is viscid in character, as oil, pitch, etc., and does not 
rapidly run off the part with which it came in contact. 
As far as popular assistance is concerned, the two may 
be regarded as presenting no essential difference. 



Burns by 
lime, caustic 
potash and 
other 
alkalies. 



BURNS BY LIME, CAUSTIC POTASH, AND OTHER ALKALIES. 

As a rule, these are troublesome, since there is not 
only removal of the cuticle (superficial skin), but de- 
struction of the soft parts below. Lime is a powerful 
alkali, and rapidly destroys the parts with which it 

(J^- Insure in The Mutual Life Insurance Co. op New York.) 



BURNS — CONTUSIONS. 29 

comes in contact. As it is useless to attempt to pick 
it off, an application should at once be made of some- 
thing to unite with the alkali, so as to form a compara- 
tively harmless preparation. Vinegar diluted with 
water, lemon juice or any other dilute acid will 
answer. These things do not undo what has been 
done ; they only prevent further mischief. The subse- 
quent treatment is the same as for burns. And what 
has been said about the alkali known as lime, may be 
said about other alkalies, potash, soda, ammonia, etc. 

BURNS BY ACIDS — SULPHURIC ACID (OIL OF VITRIOL), 
NITRIC ACID (AQUA FORTIs), ETC. 

As alkalies destroy the living tissue they come in 
contact with, so will acids of sufficient concentration. 
In such cases, applications of water will dilute 
them beyond their capacity to injure. Alkalies neu- Burns h y 
tralize acids into harmless preparations, and cooking 
soda, washing-soda or saleratus can be used for 
this purpose. Common earth, gathered almost any- 
where, applied in handfuls, contains alkali enough of 
one kind or another to entitle it to the consideration of 
being one of the best (and at the same time most easily 
secured) applications in cases of burns by acids. 



CONTUSIONS. 

These common injuries are termed "bruises" by 
most people, and are the only injuries, besides Contusions 
wounds and fractures, produced by blows or pressure, or bruises. 
The injury may be of the simple form; only a slight 
shaking or jarring of the texture, with no visible 
change, except what results from the rupture of the 

(£g~ Insure in The Mutual Life Lvsubance Co. op Nkw Yoek.) 



30 



CONTUSIONS. 



Symptoms. 



Treatment, 



blood-vessels. This is the most frequent. In the 
more severe but less frequent form, the contusion 
means broken blood-vessels, muscles, and tissues be- 
tween and around them; the parts are thoroughly 
crushed, sometimes to a pulp, damaged beyond re- 
covery, and ready to perish in the gangrene resulting 
from the extreme form of such an injury. 

In contusions, the first conspicuous symptom is that 
of shock, which generally, but not always, bears a 
relation to the extent of the injury. Thus a crushed 
finger is attended, as a rule, with much less shock 
than a crushed hand or foot. Contusion of certain 
parts, as the larger joints, breasts, and other portions 
of the body, are followed by most severe symptoms 
of shock. The pain is not always as severe as might 
at first be thought, for the nerves are so much injured 
as to be deprived of their ability to receive and trans- 
mit the necessary impression. 

The quantity of blood escaping from the ruptured 
vessels depends, in a large degree, upon the size and 
number of the vessels injured, but in some degree 
upon the space in which the blGod can accumulate. 
A single divided vessel in the scalp, owing to the loose- 
ness of the tissue in which the vessels are distributed, 
may permit a swelling, the result of the escape of 
blood, extending in area over a half of one side of the 
head. 

Discoloration is due to the color of the escaped 
blood, seen through the cuticle, and varies from black- 
ness usually indicating intense injury, through dark 
blue, purple, crimson, down to delicate pink, indi- 
cating only a blood-stained fluid. 

Treatment. — In the milder contusions, there is but 
little shock. Should there be more, place the patient 



(559" Insure In The Mutual Life Insurance Co. op New York.', 



CONTUSIONS. 31 

on the back, head not elevated, and give stimulants as 
directed. (See shock, p. 13). The next thing is to 
limit the consequences likely to ensue from the rup- 
tured blood vessel. This is best done by lessening the 
supply of blood to the part by elevating this, if pos- 
sible, above the heart, and applying cold in the shape 
of powdered ice, tied up in towels, to the part, and 
along the course of the larger vessels going to the 
injury. 

A large piece of ice secured in a towel, so that the 
pieces cannot escape, can be reduced to fine fragments 
by a blow or two against the wall. After it has 
been on for a time, water may be substituted in 
the shape of a drip ;* or several thicknesses of wet 
towel may be applied, only they must be dipped in 
cold water, squeezed out, and changed every minute 
or two. If not changed, the wet towels really act as 
poultices to the part, inviting what we should try to 
prevent. When the surgeon appears, special meas- 
ures will be directed by him. Recollect it takes a 
great deal of heat to convert ice into water, and water 
into vapor, and if the patient has not got this heat, 
symptoms of chilliness will be observed. When this 
happens the application must be stopped, and the 
moisture must be taken up by a towel ; particular at- 
tention always being paid to keep the bed-clothing 
and everything else perfectly dry and neat. 

A common accident is a "mashed finger" from the 
member getting caught in a closing window, or want 



* A pitcher, or some other vessel of water, placed higher 
than the injured parts, with a moistened string or strip of linen. 
One end of the string is placed in the water, while the other 
hangs down on the outside, so that the water will drip along 
the string from the vessel to the point of contusion. 

(J2F* Insure In The Mutual Life Insurance Co. oj> New York.) 



32 



CONTUSIONS — FRACTURES. 



Mashed fin- 
ger and its 
treatment. 



of precision in using a hammer. The firm bone be- 
neath and the blow above usually contuse (bruise) the 
tissues (veins, vessels, muscles, etc.), between, and 
often the pain and other symptoms last some days. 

Wrap up in a bandage of old muslin, and keep con- 
stantly wet with cold water, or some mild astringent 
like Pond's Extract. If there is much pain add laud- 
anum. The discoloration and swelling may remain 
some days after the pain subsides. Stimulating lini- 
ments can now be used to encourage an extra flow of 
pure blood to the part and the washing away of the 
injured blood. 



FRACTURES. 



Fractures, 
varieties of. 



These may be divided for our purposes into two 
varieties — the simple and the compound. In a simple 
fracture the bone is broken and there is some lacera- 
tion of the soft parts around it, but no break in the 
skin. In a compound fracture the skin over the seat 
of the fracture is also broken, and sometimes the bone 
protrudes. 

There is always some shock, and great pain in the 
broken bone, especially if it is stirred. If surgical 
assistance can be obtained without removing the pa- 
tient, he should be left lying quietly. All that need 
be done is to cut the clothing over the affected part 
and put on it cloths wet with cold water, which will 
allay the pain to some degree. If he has to be re- 
moved, it will be necessary to make some kind of a 
splint which will hold the limb immovable. The best 
thing for this is two pieces of board, each long 
enough to extend beyond the joints above and below 
the broken bone and a little wider than the thickness 



CKW Insure in The Mutual Life Insurance Co. of New York.) 



FRACTURES — DISLOCATIONS. 33 

of the limb. These boards should be well padded 
with cotton batting, or several layers of cloth, or 
wool, or hay, or anything that will be soft enough 
to take off the direct pressure of the boards. They 
should then be placed on each side of the limb and 
firmly bound to it by tying handkerchiefs or strips Treatment, 
of cloth around them. If boards cannot be obtained, 
anything stiff may be used, as canes or umbrellas. A 
very good splint for the leg is a pillow, which is placed 
under the leg and then bound firmly around it. The 
patient can now be placed very gently on a stretcher, 
made of a shutter or a bench, and carried very care- 
fully home. Of course it will be necessary to consult 
surgical advice in order to have the bone properly set. 
If the fracture is compound, the break in the skin 
should be treated like any other wound and some 
antiseptic directly applied. (See p. 42 et seq.) Other- 
wise the treatment is the same as for a simple fracture. 
Simple fractures may be converted into compound 
fractures by careless handling. Therefore never lift an 
injured person until you have satisfied yourself as to 
the presence or absence of a fracture. 



DISLOCATIONS. 

These occur when one bone is displaced from an- 
other at a joint. Little can be done to reduce them Dislocations, 
except by surgical aid. If it is necessary to move the 
patient before this can be had, it should be done very 
gently, and the parts kept as immovable as possible. 
If the dislocation should be compound, as rarely hap- 
pens, the open wound should be treated antiseptically. 
(See p. 42 et seq.) A joint which has been dislocated is 

%W Insure in The Mctcal Life Ihsubabcb Co. op Xew Yoek.) 



Sprains. 



84 DISLOCATIONS — SPRAINS — WOUNDS. 

much weaker than before, and can be easily dislocated 
again. 

SPRAINS. 

These are due to the stretching and tearing of the 
ligaments around a joint, and are accompanied by 
great pain and swelling. 

Hot-water applications are the best to relieve the 
pain and reduce the swelling. The joint should be 
kept absolutely at rest. The best way to secure this is 
to strap the joint for some distance above and below 
with adhesive plaster, layer upon layer. Any weak 
spot which develops in the dressing can be easily rein- 
forced by an extra layer or two. Care should be taken 
that the strapping is not so tight as to interfere with the 
circulation of the blood. This can be determined by 
noting if the part below the strapping remains warm. 
If it becomes cold and remains so, the strapping is 
probably too tight, and should be promptly removed. 

After all, sprains are very unsatisfactory to treat. 
Not infrequently they take a longer time to heal than 
a fracture, and the joint is usually left weakened. 

WOUNDS. 

For systematic study, wounds may be classified ac- 
cording to their direction, or depth, or locality; but 
Wounds, f° r our purpose they may be arranged after the mode 
varieties of. of their infliction, (i) Incised wounds, as cuts or in- 
cisions, including the wounds where portions of the 
body are clearly cut off; (2) punctured wounds, as 
stabs, pricks, or punctures; (3) contused wounds, 
which are those combined with bruising or crushing 
of the divided portions; (4) lacerated wounds, where 

(33Tlnsur« In Thb Mutual Life Insurance Co. op New YoniO 



WOUNDS. 35 

the separation of tissue is effected by or combined with 
tearing of them; (5) poisoned wounds, including all 
wounds into which any poison, venom or virus is in- 
serted. 

i 

Any of these wounds may be attended with ex- 
cessive hemorrhage or pain or the presence of dead 
or foreign matter. As all wounds tend to present 
several common features, a few words will be said 
about these before describing the distinctive charac- 
teristics of each. 

The first is hemorrhage (bleeding). This depends, 
as to quantity, upon several conditions, the chief of 
which is the size of the blood-vessels divided; and, 
to a degree, upon the manner in which it has been 
done. A vessel divided with a sharp instrument pre- 
sents a more favorable outlet for the escape of blood H h 
than one that has been divided with a blunt or serrated f rom 
instrument, or one that has been torn across. Except wounds, 
in the first named, the minute fringes or roughness 
necessarily left around the edges of the vessel at the 
point of division retard the escape of blood and fur- 
nish points upon which deposits of blood, in the shape 
of clots, can take place. Hence, all other things being 
equal, an incised wound is usually attended with more 
hemorrhage than contused or lacerated wounds. 

The bleeding may be simply an oozing from the 
smallest blood-vessels, called the capillaries. This Capillary 
form of bleeding is not of much consequence, and can hemorrhage, 
easily be checked. 

It may be from a vein, and is then called venous. 
The veins are larger vessels, which are carrying the 

blood back to the heart. The blood from them is , emorr t a & e 

from veins. 

purple and flows evenly without any force. 



{XW Insure in Thb Mutual Lipb Insurance Co. op New York.) 



36 



WOUNDS. 



Hemorrhage 

from 

arteries. 



Other 
symptoms 
of wounds. 



The bleeding may be from an artery, and is then 
called arterial. The arteries are large distributing 
vessels which carry the blood from the heart to the 
extremities. The blood from them is bright red and 
flows in pulsations or jets, with some force. This is 
the most dangerous form of bleeding and the hardest 
to control. 

While we are not able sometimes to tell the kind 
of hemorrhage from a given wound, we should al- 
ways try to determine it, for there may be consider- 
able difference in the treatment. 

There is always some pain present in a wound, and 
this varies largely with the location and extent of the 
injury. Often it is not near as much as we expect to 
find. 

In wounds of large size there is some shock, and 
when the wound is very extensive and crushing, the 
state of shock may be profound, even up to uncon- 
sciousness. In some people the mere sight of blood 
may be enough to cause fainting. This, of course, is 
very different from shock and much easier to treat. 



Treatment. 



TREATMENT. 

There are several indications to meet in the treat- 
ment of a wound, and it can best be described under 
the following heads : 

First — To stop bleeding. 

Second — To clean the wound. 

Third — To dress the wound. 

Fourth — To relieve the other symptoms. 

First. — Nature stops bleeding by causing the blood 
to coagulate into little clots, which plug up the open 
mouths of the divided blood-vessels and prevent any 
more blood from flowing out. The smaller the blood- 

(B^* Insure in The Mutual Life Insurance Co. op New York.) 



WOUNDS. S7 

vessel and the more sluggish the current of blood in 

it, the quicker this is done. Therefore, this coagula- How 

tion occurs quickest in the capillaries, next in the st0 p the 

veins, and last of all in the arteries. All that we can hemorrhage, 

do is to aid nature in this by making the current of 

blood flow slower or by making the mouths of the 

vessels smaller. 

If the wound is small and the bleeding mostly capil- 
lary oozing, the part should be elevated, and firm 
pressure applied directly to the wound, preferably 
through a clean wet cloth. A few minutes of this will ca piiiaries 
usually be enough. If it does not, we can try again, 
or we can apply water just as hot as can be borne with- 
out scalding, or we can apply pressure with a piece 
of ice wrapped up in a clean handkerchief or thin cloth. 
Heat and cold contract the blood-vessels, and pressure 
not only does this, but slows the current of blood. 

If the bleeding is from a small vein, the above meas- 
ure will usually be enough. If the vein is larger, the 
pressure may have to be applied for some time. To from veins 
do this, roll up a handkerchief or clean cloth into a 
small hard wad, wet it thoroughly and then bind it 
firmly over the wound by means of another handker- 
chief or a strip of cloth. It may have to be kept on 
for some hours before the clots in the vessels are 
strong enough. The pressure should be sufficient to 
check the bleeding entirely. 

If the bleeding is from a small artery, the above 
measures will often be enough, but if the artery is 
of any size, they alone will not do. As arterial bleed- from artenes - 
ing is very fast, whatever we do must be done quickly. 
We must bear in mind that besides applying pressure 
and heat or cold directly to the wound, what we wish 
to do is to slow the current of blood in the artery so 

(E©~ Insure in The Mutual Life Insurance Co. op New York.) 



38 



WOUNDS. 



that firm clotting can take place. Now the blood is 
flowing in the artery from the heart to the wound. 
Therefore, if we can compress the artery above the 
wound, we diminish or stop altogether the flow of 
blood toward the wound. We will first consider the 
case of a wound in the upper extremity. The large 
Course of the artery which supplies the arm passes out of the chest 
main artery oyer the first rib and un( j er t he collar-bone. It then 

reaches the side of the arm just behind and below the 
front fold of the arm-pit. It now passes down the 
side of the arm, gradually turning to the front, until, 
at the elbow, it is right in the middle. Its course is 
shown in the accompanying cut. 



of the upper 
extremity. 




Note — The arm and forearm, with dotted lines, indicate the 
course of the arteries, and points at which pressure can be most 
judiciously applied. 

The arrow points the course of the current of the blood of 
the artery, from the heart to the extremities. 

(B2P*Iiisure in Tub Mutual Life Insueance Co. of New Toes.) 



WOUNDS. 



89 



The part under the collar-bone is called the sub- 
clavian artery, that in the arm-pit the axillary, and 
that along the side of the arm the brachial. Pressure 
can best be applied along the brachial, the pulsations T 
of which can be felt. It should be outward and slightly of arter { a i 
backward against the bone, and can easily be done by hemorrhage 
means of the fingers or thumbs firmly applied. "While from the 
one person is doing this, another can tie in a handker- u PP er 
chief a small round stone or a piece of wood or a extremit y- 
watch, or anything that is hard. If nothing like that 
can be found, tie several firm hard knots into one 
mass in the middle of the handkerchief. Lay the 
stone or knot over the artery right by the fingers 
that are compressing it. Then tie the ends of the 
handkerchief around the arm in a loose knot, through 
which is slipped a stick. By twisting this around and 
around we tighten the handkerchief until the blood 




(SSf Insure in Thb Motdal Lipb Insctbancb Co. op New York.) 



40 



WOUNDS. 



Course of the 
main artery 
of the lower 
extremity. 



entirely stops flowing, but no tighter. This consti- 
tutes a "Spanish windlass" and is very effective. Its 
application is well shown in the preceding cut (p. 39). 

If the wound is in the forearm, we apply this just 
above the elbow. If the wound is high up in the arm, 
it may be necessary to compress the subclavian. This 
is done by thrusting the fingers or the handle of a 
large key firmly down behind the collar-bone and 
pressing the artery firmly against the first rib. It is 
difficult and painful to maintain pressure here for 
any great length of time. 

In the lower extremity the artery reaches the thigh 
just where it joins the abdomen, and it can easily be 
felt pulsating about the; middle of the groin. It then 
passes down the inner surface of the thigh, gradually 
turning backward until it can be felt at the back of the 




Note — The thigh and groin, with dotted lines, suggest the 
course of the large arteries, and point at which pressure can be 
most successfuly used. 

The arrow indicates the direction of the current of the blood 
of the artery, from the heart to the extremities. 

(tt^*Insure in The Mittual Life Insurance Co. op New York.) 



WOUNDS. 



41 



knee in the middle between the cords. In the thigh 
it is called the femoral artery, back of the knee the 
popliteal. Its course is shown in the preceding dia- 
gram (p. 40). 

Pressure can be used as indicated, and the applica- 
tion of the Spanish windlass is well shown in this cut : 




Treatment 
of arterial 
hemorrhage 
in the lower 
extremity. 



If the wound is below the knee, we can usually con- 
trol the hemorrhage by applying pressure to the pop- 
liteal artery, although as this is rather deeply situated, 
we may find it necessary to apply it to the femoral as 
shown in the above cut. 

If an artery in the scalp is cut, firm pressure over 
and around the wound will always control it. 

It is well to remember in a great emergency that 
nearly any bleeding can be checked for a time by Direct 
thrusting the fingers into the wound and pressing di- pressure, 
rectly upon the bleeding point. 

Second. — After the bleeding has entirely stopped, 
the next step is the cleansing of the wound. First 

(|^*Insure in The Mutual Life Insubance Co. op New Yoek.) 



42 



WOUNDS. 



Cleaning of 
the wound. 



Ways in 
which 
wounds 
heal. 



we ought to make sure that our hands and our clothes 
are thoroughly clean. We should scrub our hands 
with soap and hot water and a nail-brush. It is ad- 
visable, if possible, to boil the cloths we use and the 
water we need for washing the wound. The surface 
around the wound should be thoroughly washed with 
soap and water. The wound itself should be very 
gently washed, and any clots lying on its surface 
carefully wiped or washed away. Then all the soap 
should be washed away with plenty of water. After 
this we should apply liberally to the surface of the 
wound, and all around it, one of the following solu- 
tions: Carbolic acid, 1-30; or corrosive sublimate, 
1-2000; or boric acid, 5-100. (See pages 164-165.) 

Third. — The next step is dressing the wound. This 
varies considerably, according to the nature of the 
wound. Wounds heal usually in one of two ways, by 
first intention or by granulation. Healing by first 
intention occurs when the wound is clean and the 
edges can be brought together and kept so. There is 
very little reparative material needed, the time of heal- 
ing is short, and the scar left is thin and inconspicu- 
ous. Healing by granulation occurs when the edges 
of the wound cannot be brought together. The repara- 
tive material is poured out abundantly on the surface of 
the wound in the form of little granulations. These 
gradually increase and grow until they bridge over 
the gap in the tissues made by the wound. This 
takes a longer time, and the scar left is much larger. 
As the scar keeps contracting for a considerable time 
after the healing is completed, it sometimes causes 
serious deformities. When a wound becomes in- 
flamed, it is due to the presence of certain 
germs which multiply in the wound and irri- 

(JtSPInsure in The Mutual Life Insurance Co. of New Yoek.) 



WOUNDS. 



43 



tate it. These cause suppuration, the formation 
of "matter" or pus, which prevents healing by first 
intention. These germs are very common, and can 
only be kept out of a wound by thorough cleanliness 
and the use generally of some antiseptic which destroys 
them. 

If it is a small incised wound, the edges can be 
brought together by gentle pressure, and three or four 
layers of flexible collodion (see page 165) applied, for 
some distance around and over the wound, each layer 
being allowed to dry before the next is put on. If we 
have not this, we can cover it with adhesive plaster. 
If it is a large incised wound, we have to use adhesive 
plaster, putting the strips across the line of the wound wound, 
and taking care that the edges of the wound are 
brought close together. The accompanying cut shows 
this very well, although the strips of plaster may have 
to be placed closer: 



Dressing of 
an incised 




(J2^"Insure in The Mutual Lipb Insurance Co. o» Nbw York.) 



44 



WOUNDS. 



Treatment 
of an 
inflamed 
incised 
wound. 



Dressing of 
a lacerated 
or contused 
wound. 



We then dust liberally over the entire length of the 
wound some dry antiseptic powder, such as iodoform, 
bismuth subnitrate, or the bismuth and boric acid 
mixture (see page i64). Over this we place two or 
three wide layers of lint, or absorbent cotton, or clean 
cloths which have been well boiled and dried. The 
whole is kept in place by a few turns of a bandage 
or strips of cloth or plaster. We are thus careful in 
the dressing in order to prevent suppuration. If the 
wound does not show signs of inflammation, such as 
pain, heat and throbbing, we can leave this dressing 
on for a week or more, and when we take it off we 
expect to find the wound healed. When a wound be- 
comes inflamed, we recognize the condition by these 
signs. In such a case we remove the dressing and 
see in what part the suppuration is taking place. We 
then take off the strips of plaster over that part. This 
permits the pus to escape if it has not already done 
so. We then wash out the cavity gently, but thor- 
oughly, with one of the antiseptic solutions and dust 
into it one of the dry antiseptic powders. This dress- 
ing will have to be repeated every two or three days. 
It is of advantage to give a free purgative, such as 
Epsom or Glauber's salts, when a wound becomes 
inflamed. 

If a wound is lacerated or the edges are badly con- 
tused, we do not expect to get healing by first in- 
tention. We do not try to bring the edges together, 
for it would be useless. Hence we omit the plaster in 
dressing such a wound, but in all other respects it 
should be treated like an incised wound. Inflammation 
is much more common in this class of wounds, but 
oftentimes can be avoided by care. Even if it does 
not occur, we usually have to change the dressings 

(i2P~Insure in The Mutual Life Insurance Co. of New York.) 



WOUNDS — BITES. 45 

every three or four days, for the discharges from the 
wound are very apt to soak through in that time. 

Fourth. — If the wound is incised, there is little 
shock, as a rule; but when the wound is very large 
or much lacerated or contused, shock is apt to be quite 
marked. It should be treated as described on p. 13. 

If there is much loss of blood, fainting is apt to 
occur. It should be treated as described on pp. 13-14; 
but care should be taken not to over-stimulate, for 
then we may start the bleeding afresh. As fainting in 
itself causes a slowing of the blood-current, it is of 
some assistance in stopping hemorrhage. 

If there is much pain we will have to give some 
anodyne. Laudanum is the best, in doses of five drops 
every two or three hours. 

BITES. 

Independent of the consideration whether any 
poison has been introduced, a bite may be regarded as 
a lacerated as well as a contused wound. There is 
usually a good deal of sloughing of the bitten parts, Bites, 
and no small amount of pain, owing to the nature of 
the wound. Care should be taken to remove from the 
wound any particles of clothing, should any have been 
forced into it; then wash out with tepid water and cas- 
tile soap. Usually the part is so much contused that 
no effort is made to secure adhesion of the opposite 
sides of the wound ; but it should be treated as any 
other lacerated, contused wound. 

BITES OF DOGS. 

Rabid dogs are much less frequent, perhaps, than is 
generally thought ; and a rabid dog might bite many 

(£5P"Insure in The Mutual Life Insurance Co. op New York.) 



46 



bite OF RABID DO<3. 



Rabies, or 
hydro- 
phobia. 



Treatment of 
the wound. 



human beings without necessarily communicating 
hydrophobia. It is stated that of dogs bitten 
by others known to be hydrophobic, scarcely more 
than one in four become affected ; and it is likewise said 
that among human beings, when no precautions are 
taken, not more than one in ten or fifteen are affected 
after being bitten. The celebrated surgeon, John 
Hunter, knew of twenty-one people who were bitten 
by the same dog, and only one of the number had 
the hydrophobia. Besides, many persons have un- 
doubtedly died, after having been bitten, with con- 
vulsions, not of hydrophobia, but the result of anxiety 
and fright. One well-known physician, after having 
been bitten, as a precautionary measure blew out his 
brains. 

Treatment. — Remove the clothing, if any, from the 
bitten part, and apply a temporary ligature above the 
wound. This interrupts the activity of the circula- 
tion of the part, and to that extent delays absorption 
of the poisonous saliva by the severed blood-vessels 
of the wound. While other things are being hurriedly 
prepared for, some one whose lips and mouth are 
free from breaks might attempt suction of the wound. 
The material extracted by the act, apparently chiefly 
of blood, should of course at once be ejected from 
the mouth of the person giving the assistance. The 
bite is really a lacerated and contused wound, and 
lying in the little roughnesses, and between the shreds, 
is this poisonous saliva. If by any means these pro- 
jections and depressions affording the lodgment can 
be removed, the poison must go with them. If done 
with a knife, the wound would be converted practically 
into an incised wound, and would require treatment 
as such. If a surgeon is about, he would probably 



(ft^Insure in The Mutual Life Insurance Co. op New York.) 



BITE OF RABID DOG. 47 

stand a probe upright in the wound, and with a sharp 
knife cut the entire injured portion out. Professional 
aid is not always at command, and in such a case it 
would be well to take a poker or other suitable piece 
of iron, heat it red hot, at least, in the fire, wipe F 
off and destroy the entire surface of the wound. As treatme nt 
fast as destroyed, the tissue becomes white. An iron of the 
at white heat gives less pain than one "black hot,'' wound, 
as smiths say; for in the latter instance the heat is 
scarcely sufficient to destroy, but only irritates ; while 
in the former, the greater heat at once destroys the 
vitality of the part with which it comes in con- 
tact. With a properly heated iron, not only the surface 
is destroyed, but the destructive influence extends be- 
yond and into the healthy tissue, far enough, if no 
point is neglected, to assure the purposes for which 
it is used. 

Some are inclined to think that if the wound is at 
once well wiped out, and a stick of solid nitrate of 
silver (lunar caustic) rapidly applied to the entire sur- 
face of the wound, little danger is to apprehended. 
It acts, but in a milder degree, like the heat of the 
iron upon the tissues. In case the heat or the caustic 
has been used, poultices and warm fomentations 
should be applied to the injury to hasten the sloughing 
of the part whose vitality has thus been intentionally 
destroyed. 

There is a strange belief among the ignorant, par- 
ticularly among the people from Ireland, that, whether £> g should 
the dog was "mad" or not at the time of giving the bekeptaiive 
bite, if it should become so at any future time, the if possible, 
disease will appear in whatever individual the animal 
has bitten. A dog, after having bitten a person, is 
apt, under this mistaken belief, to be at once slain. 



({^"Insure in The Mutual Life Insurance Co. op New York.) 



48 RABIES IN THE DOG. 

This should not be done, but the suspected animal 
placed in confinement and watched, under proper safe- 
guards, for the appearance of the disease. Should 
no satisfactory appearances indicate the disease in 
the dog, it can be seen in a moment what unneces- 
sary mental distress can be saved the person bitten 
and his friends. 

Mr. Youatt, whose description of canine madness is 
generally quoted and accepted, says : "The disease 
manifests itself under two forms — the furious form, 
characterized by augmented activity of the sensorial 
and locomotive systems, a disposition to bite and s. 
continual peculiar bark. The animal becomes altered 
in habits and disposition, has an inclination to lick 
or carry inedible substances, is restless and snaps in 
the air ; but is still obedient and attached. Soon there 

c , is loss of appetite, and thirst: the mouth and tongue 

Symptoms of • rr ' & 

rabies in the swollen ; the eyes red, dull and half-closed ; the skin 
dog. of the forehead wrinkled ; the coat rough and staring ; 

the gait unsteady and staggering; there is a periodic 
disposition to bite ; the animal in approaching is often 
quiet and friendly, and then snaps ; latterly there is 
paralysis of the extremities ; the breathing and degluti- 
tion become affected by spasms ; the external surface 
irritable, and the sensorial functions increased in ac- 
tivity and perverted; convulsions may occur. These 
symptoms are paroxysmal; they remit and intermit, 
and are often excited by sight, hearing or touch. 

"The sullen form is characterized by shyness and 
depression, in which there is no disposition to bite, and 
no fear of fluids. The dog appears to be unusually 
quiet, is melancholy and has depression of spirits; 
although he has no fear of water, he does not drink. 
(The fear of water, it should be said, is acquired by 

(t^" Insure in The Mutual Life Insubance Co. op New Yobk.)J 



RABIES IN THE DOG. 49 

experience, the effort of swallowing being attended 
with spasm of the muscles of the throat, afterward 
often extending to the rest of the muscles of the body.) 
"He makes no attempt to bite, and seems hag- 
gard and suspicious, avoiding society, and refusing 
food. The breathing is labored, and the bark is harsh, 
rough and altered in tone ; the mouth is open from the 
dropping of the jaw; the tongue protrudes and the 
saliva is constantly flowing. The breathing soon be- 
comes more difficult and laborious; there are tremors, 
and vomiting, and convulsions." 



(j£g~ Insure in The Mutual Life Insurance Co. op New York.) 



SECTION II. 



EMERGENCIES. 



As a preparation for emergencies, there can be 
nothing better than a policy in The Mutual Life 
Insurance Company of New York. 



EARACHE. 53 



EARACHE. 

Evaporate the alcohol from a teaspoonful of laud- 
anum (page 57); add half as many drops as you 
started with of glycerine or sweet-oil ; make it milk- 
warm, and pour into the ear, catching hold of the tip 
and pulling upward toward the crown of the head 
(page 59) ; or, wet a scrap of linen in a teaspoonful of 
laudanum, dry before a fire, cut into bits, place in the 
bowl of a tobacco-pipe, light it, cover with a coarse 
handkerchief, insert end of the stem (mouthpiece), Earache, 
suitably protected so as not to hurt, into the ear of the 
child. Then apply the lips to the bowl and blow the 
smoke from the burning opium of the laudanum into 
the ear. Tobacco alone can be used in the same way. 
Either of these methods will afford instant relief in 
most cases. Frequent syringing with decidedly warm, 
almost hot water, is also highly recommended by 
eminent aurists. Tenderness, redness, or swelling of 
the tissues immediately behind the ear are danger 
signals, and should be promptly heeded, as they 
indicate serious mischief in the underlying bony 
structure. Make cold applications (small compresses 
kept on ice serve the purpose) and summon a phy- 
sician. If the pain continues, consult a doctor with- 
out delay. It may be the beginning of severe in- 
flammation of the ear, which sometimes proves fatal. 

Any chronic discharge from the ear should be ~, . ,. 
.... . Chronic dis- 

treated until it is entirely well. It may occasion very charge from 
little inconvenience, but, on the other hand, it may the ear. 
cause a severe inflammation of the brain, which is 
usually fatal. 

Insure in The Mutual Life Insurance Co. op New York. ) 



54 



TOOTHACHE — FACEACHE — CROUP. 



Toothache. 



Faceache. 



Varieties. 



Symptoms. 



TOOTHACHE. 

This is sometimes neuralgic, and sometimes due to 
decay. Heat to the face outside, and a heated half of 
a fig held inside, often relieve the former kind, and 
sometimes afford temporary relief in the latter kind. 
If the cavity can be cleansed out with a broom-splint 
and filled with cotton steeped in some of the evap- 
orated laudanum much comfort will be found from it. 

FACEACHE. 

This usually is neuralgic, and heat applied is always 
grateful. A small hop-pillow heated and held to the 
face is useful; or the face may be bathed with lauda- 
num, tincture of arnica or any soothing substance. 
Mustard-plasters should not be used, as they leave a 
conspicuous mark, and may blister. Ordinary Cayenne 
pepper mixed into stiff paste with an equal bulk of In- 
dian-meal and honey, is quite as active and useful, 
and does not blister the skin. 

CROUP. 

Croup may be either membranous or spasmodic. 
The former is really a variety of diphtheria, and should 
be treated as such. The latter is by far the more 
common, however, and is often produced by the pres- 
ence of undigested or indigestible food. 

Some young children seem peculiarly prone to this 
trouble. The well-known hoarseness of the voice, the 
rough, brazen cough coming on toward night, always 
suggests the possibility of an attack of croup. These 
symptoms, showing increased difficulty of breathing, 
rapidly grow worse, and all that is to be done must be 
done quickly. Of course, a physician should be sent 
for. 



(J3T Insure in The Mutual Life Insurance Co. op New Yoek.) 



Treatment. 



CROUP — CONVULSIONS. 55 

The first thing is to get the child to vomit, by giving 
it every few minutes a teaspoonful of syrup of ipecac, 
followed by draughts of warm water. As soon as 
vomiting commences, a warm bath should be given, 
the skin well dried with a soft warm towel, and the 
child returned to bed. A properly made and carefully 
applied warm poultice, or flannels wrung out of hot 
water, may be placed against the upper and front 
part of the chest, care being taken after removing it 
to substitute a warm, dry flannel. In doing these 
things, do not expose the skin to the slightest draught. 
A mustard paste, one part mustard to 15 or 20 parts 
of flour, is also useful, especially so if there is any ac- 
companying bronchial inflammation. Small doses of 
paragoric or sweet spirits of nitre, 10 drops of either 
in water repeated every two hours may be given if the 
cough is troublesome. 

After the child vomits, or should it seem weak, five 
drops of the aromatic spirits of ammonia in a teaspoon- 
ful of water may be given every ten minutes until four 
or five doses shall have been taken. This is for a child 
of about two years of age. 

The stomach of a child susceptible to croup can- 
not be too carefully guarded, especially if it is suffer- 
ing from what is popularly known as a "cold." 

CONVULSIONS IN CHILDREN. 

These, sometimes called "fits," often result from 
undigested food in the stomach or bowels. The first 
thing to be done is to put the child in a bath of warm Convulsions 

-water. * n children. 

In the course of a few minutes — which seems much 
longer to the mother and friends — the spasm relaxes 
enough to permit an emetic to be given to dislodge 

83F" Insure in Thk Mutual Life Insurance Co. ov Nbw Yobk.) 



56 FOREIGN BODIES IN THE EYE. 

whatever may be in the stomach. The syrup of 
ipecac, as directed under "Croup," is as good as any- 
thing else for the purpose. 

Sometimes these convulsions are one of the early 
symptoms of scarlet fever, measles, or other diseases 
peculiar to childhood. 

FOREIGN BODIES IN THE EYE. 

Particles of cinder, dust, or fragments of metal, often 
get into the eye, and cause a good deal of trouble. 
Generally they are dislodged and washed out by the 
Methods of extra secretion of tears due to the irritation, but some- 
removal, times it is necessary to resort to some process of ex- 
traction. A popular and often successful plan is to 
take hold of the lashes of the upper lid and separate 
it from the eyeball, so that the lashes of the lower 
lid will slip up in the space, acting as a brush to the 
inner surface of the upper eyelid. This cannot, as a 
rule, remove anything from the eyeball. A better way 
is to hold a knitting needle or a match over the upper 
lid, close to and just under the edge of the orbit, 
firmly, but without much pressure. Then seize the 
lashes of that lid by the fingers of the disengaged 




&W Insure In The Mutual Life Insurance Co op New York.) 



FOREIGN BODIES IN THE EYE. 



57 



Removal, if 
imbedded. 



hand, and gently turn the lid upward and backward 
over the needle, or the substitute used. Movement 
of the eyeball by the sufferer, in a strong light, usually 
reveals the presence of the intruding body, so that by 
means of a corner of a silk or cambric handkerchief, it 
can be detached and removed. 

Should the foreign body be imbedded in the mu- 
cous membrane covering the eyeball or the eyelid (con- 
junctiva), a steady hand and a rigid instrument will 
usually lift it out. A very useful spud for such a pur- 
pose is the butt of a clean pen. A drop or two of 
cocaine solution, 5 or 10 per cent., will deaden the 
sensibility of the eye, and materially facilitate the re- 
moval of the foreign body. It dilates the pupil, but 
this effect passes off in a few hours. 

The foreign body often cannot be seen, but the per- 
son assures us that he feels it. Usually he does not 
really feel the presence of the body, so much as the t ^ e a fter-irn 
roughness (really a wound) left by it. In such a case, tation. 
or even if the body has been seen and removed, a 
soothing application to the injury is as useful as the 
same thing applied to a wound of the hand. Take a 
spoon or cup, heat it, and pour in a few drops of 
laudanum. It will soon become dense and jelly-like. 
A few drops of water added will dissolve this gummy 
material, and the liquid thus formed may be applied 
by the finger to the "inside of the eye," as they say. 
Laudanum is opium dissolved in alcohol. The al- 
cohol is somewhat irritating, but is easily evaporated 
by the gentle heat, leaving an extract of opium, which 
is dissolved in the water afterward added. A still 
better application for this sense of irritation is made by 
dissolving a teaspoonful of boric acid, either powdered 
or crystalline, in a teacupful of warm water. A few 



Treatment of 



(dflnsure j n x HB Mutual Life Insurance Co. op Xew York.) 



58 FOREIGN BODIES IN NOSTRILS AND EAR. 

* 

Pink-eye, or drops of this can be dropped in the eye every Half 
conjuncti- hour or so. This is also an excellent thing for that 
vit *s. condition of the eye known as pink-eye, or acute 

conjunctivitis. If the inflammation is at all marked, 
it is well to combine cold applications with the drops 
by keeping cloths wet with ice-water constantly on the 
eye. It should be remembered that pink-eye can easily 
be transferred to the sound eye, or to another person, 
and precautions should be taken to prevent this. 
In no case use any of the popular "eye-waters" or 
"salves." 

A not uncommon accident is the lodgment of a frag- 
ment of lime in the eye. The delicacy of the organ, 
and the activity of this powerful alkali, require all 

Lime in the *^ at * s to ^ e done to ^ e done at once. Do not waste 
eye. time by attempting to pick it out, but neutralize the 

alkali by a few drops of vinegar (which is dilute acetic 
acid) in a little water. A few drops of lemon juice, in 
a little water, will answer just as well. Even when this 
is done rapidly, the ulceration caused by the alkali will 
be some days in disappearing. In all cases where lime 
has entered the eye, no time should be lost in going to 
a surgeon. 

FOREIGN BODIES IN NOSTRILS AND EAR, 

The curious disposition of children to insert foreign 
bodies, as grains of coffee, corn, peas, pebbles, etc., 
up the nostrils, and into the ear, is too well known 
to need more than a mere allusion. If the body is 
soft, it absorbs moisture from adjacent parts, becomes 
swollen, and more difficult to remove. If the body 
is hard, the irritation and inflammation soon set up 
by it in contiguous parts materially increase the diffi- 
culties of removal. Hence the sooner these sub- 

(S^*Iiisure in The Mutual Life Insurance Co. op New Yoke.) 



FOREIGN BODIES IN NOSTRILS AND EAR. 



59 



stances are removed, the more easily will it be accom- 
plished. 

If the foreign body is up the nostril, the child should 
be made to take a full inspiration ("a full breath") ; 
then if the other nostril be closed with the finger, and 
the mouth with the hand, the air of the lungs, escaping 
through the nostril closed by the foreign body, 
assisted by a sharp blow from the palm of the hand 
to the back, will often expel the substance. 

If it will not escape in this way, and it is near the 
opening of the nostril, compression by the fingers, 
just above, will prevent it getting further up, and it 
can be hooked out with the bent end of a wire or 
bodkin. Should these measures not remove the for- 
eign body, the child must at once be taken to a 
surgeon. 

Foreign bodies in the ear are more troublesome to 
deal with. No effort to remove them with a probe, or 
anything of the kind, should be made by any one 
except a professional man, for fear of permanent in- 
jury to the ear. The head of the child, face downward, 
should be firmly held between the knees, and with a 
Mattson's or Davidson syringe a stream of tepid water 
should be injected into the ear. The nozzle of the 
syringe should not be introduced into the cavity, as 
its presence may prevent the dropping out of the de- 
sired body after the water has been forced past and be- 
yond it. 

Should this means not succeed, consult a surgeon 
without delav. 

Insects sometimes get into the ear. The best way 
of getting them out is to hold the head of the person 
with the disabled ear upward, and fill the cavity with 
sweet-oil or glycerine. This drowns the animal, by 



Treatment of 
foreign 
bodies in the 
nostril. 



Treatment of 
foreign 
bodies in the 
ear. 



Insects in the 
ear. 



(t^TInsore in Ths Mutual Life Insurance Co. op New York.) 



60 



BLEEDING FROM NOSE AND THROAT. 



Bleeding 
from the 
nose. 



Spitting of 
blood. 



closing up its breathing pores, and in a short time it 
floats to the surface of the fluid used. The tube of the 
ear is slightly curved, and when straightened somewhat 
by catching hold of the upper tip, and gently pulling it 
upward toward the crown of the head, the liquid flows 
in more readily. 

BLEEDING FROM THE NOSE. 

Bleeding from the nose is sometimes troublesome, 
but not often fatal. In severe and prolonged 
cases professional assistance can usually be had, 
and if not, the remedies and appliances to be 
used, cannot be properly described here. The most 
important thing is not to disturb the clot, closing 
the little ruptured vessels, by blowing the nose. 
The person should be kept flat on his back, 
the collar loosened and cold applied to the back 
of the neck. Do not forget that a small 
amount of blood will stain quite deeply a large 
amount of water. One common practice should be 
carefully avoided — that of holding the head over a 
vessel and letting the blood drip into it from the 
end of the nose. This attitude simply congests the 
head and prolongs the bleeding. 

SPITTING OF BLOOD. 

If the blood comes from the lungs, it is suggestive 
of trouble there, but not always so in young people, 
especially in young women. The amount of blood 
lost is in itself rarely fatal. As salt is always given 
in such cases, it has acquired a good deal of popular 
confidence for arresting the loss of blood. It and frag- 
ments of ice may be given, and the person made to 
lie quietly on the back. Of course, a doctor should 
be sent for at once. 



(Et^~ Insure in The Mutual Life Insurance Co. op New Yoek,) 



POISON-VINE — SUNSTROKE. 61 

POISON-VINE ERUPTION. 

Several varieties of the Rhus, popularly known as 
the swamp-sumach or poison-sumach, poison- vine, and 
poison-oak, when brought in contact with the skin of 
many persons, produce itching, redness, a sense of 
burning, tumefaction, and even blistering. Sometimes 
the swelling is so great as to disguise the features. Poison-vine 
Some persons coming within the influence of merely eru P tion - 
the emanations from different species of the Rhus ex- 
perience the same symptons. The poisonous effects 
are usually observed shortly after exposure, and begin 
to decline within a week. 

Weak alkaline solutions — say a teaspoonful of com- 
mon baking soda to a quart of water, or even lime- 
water — kept to the part by dipping pieces of linen in 
them, are useful in allaying the inflammation. The 
addition of laudanum relieves the pain. Weakened 
lead-water is also recommended. Cream from milk 
is perhaps as useful as anything else. 

SUNSTROKE. 

Ordinary exhaustion, from overwork in a heated at- 
mosphere, is about the only disorder likely to be con- 
founded with sunstroke. The distinction between the Sunstroke. 
two will not be attempted here, as there is no essential 
difference in the treatment. 

Contrary to what is generally supposed, exposure of 
the head to the direct rays of the sun is not essential 
for sunstroke, as statistics show that it may occur in the 
shade, under shelter, and even at night ; sometimes, Causes, 
even in persons who have not been exposed to the sun 
for days before. Intense heat, either solar or artificial, 
is necessary to produce it. Workmen in sugar re- 



(S3F* Insure in The Mutual Life Insurance Co. op New York.) 






62 SUNSTROKE. 

fineries and laundries, engine and boiler rooms, are not 
infrequently subject to it. 

Sunstroke appears to be decidedly favored by intem- 
perance and want of acclimatization, and the debility 
which has been brought on by fatigue in a heated at- 
mosphere also favors it. Occupants of badly-venti- 
lated sleeping apartments appear to be oftener at- 
tacked than those who sleep in purer air. 

Symptoms. — It is generally thought by the non-pro- 
fessional that the symptoms of sunstroke come on 
without any warning whatever. Most cases, however, 
Warning are preceded by pain in the head, wandering of the 

symptoms. thoughts, or an inability to think, disturbed vision, 
irritability of temper, sense of pain or weight at the 
pit of the stomach, inability to breathe with the usual 
ease and satisfaction. These symptoms become more 
marked until insensibility is reached, sometimes pre- 
ceded by delirium. 

The skin is very hot, usually dry, but when not dry, 
covered with profuse perspiration. The face is dusky, 
or, as the saying is, "blue" ; breathing rapid and short, 
Symptoms of Q r slow and sighing. The action of the heart, indi- 
t c attack. ca ted to the hand placed over it, is weak, rapid and 
tremulous, often compared to the "fluttering of a 
bird." In many instances, from what is popularly 
termed the commencement of the attack until it ends 
in death, the patient does not move a limb, nor even 
an eyelid. 

The breathing gradually fails; the blood therefore 
is not purified in the lungs, as is indicated by the 
livid, purplish appearance of the surface. We are led 
by it to conclude that death takes place by asphyxia, 
as described under the heads "Drowning," "Suffoca- 
tion," etc., pages 15-20. 

(SE^° Insure in The Mutual Life Insurance Co. op New York.) 



SUNSTROKE. 68 

While we know that certain things favor the 
disorder, that a high temperature is necessary to pro- 
duce it, and advise certain measures of precaution 
and relief, found by experience useful in such cases, 
but little is really known of the nature of the malady. 
It would seem that the great heat of the body induces 
some change in the character of the blood, disqualify- 
ing it for the usual purposes of blood. From this 
peculiar condition of the blood, the portions of the 
brain or nervous system controlling the action of the 
muscles of the chest and heart lose their ability to 
superintend properly the movements of breathing and 
circulation, and, as said before, the person dies from 
asphyxia. 

Treatment. — The person attacked should be carried 
at once to some shady spot. If a house in the neigh- 
borhood has a bath-tub large enough to hold the T 
entire body, he should be taken there. The tub should if a bath-tub 
be filled with cool water. If it cannot be obtained cool is available, 
enough, ice should be added. The entire body should 
then be immersed, with the exception of the head, 
over which an ice-cap should be placed. This can be 
made very easily by putting a large fragment of ice 
in a towel and striking it a few times against the 
wall, thereby breaking it into small pieces. The pa- 
tient should be kept in the bath for ten or fifteen min- 
utes and then placed in a bed between blankets with- 
out being dried. If, at the end of fifteen minutes 
more, he shows no signs, or very feeble ones, of re- 
turning consciousness, he should be replaced in the 
bath and treated as before. This can be repeated at 
intervals of fifteen minutes, until consciousness is quite 
well established and the bodv remains cool. After 
being quite comfortable for some time, it OCCasion- 
Ct^* Insure in The Mutual Lifs Insurance Co. op New Toes.) 



64 



SUNSTROKE. 



Treatment, 
if a bath-tub 
is not 
available. 



Other 

measures of 
treatment. 



Preventive 
measures. 



ally happens that the person becomes stupid and his 
body gets hot again. If this occurs, repeat the bath, 
as before. 

If no bath-tub is available, the person should be 
placed in some such shady spot, as a large room, 
the shade of a building, or a tree. His clothing 
should be stripped off and his body and head thor- 
oughly sponged w ; th ice-water for twenty minutes, 
using it very liberally. This should be repeated in 
fifteen minutes, as in the case of the bath. In fact, 
there is no difference in the two methods, except 
that by means of a tub we can apply cold water much 
more thoroughly. 

Artificial respiration, until the natural breathing re- 
turns, may be resorted to, if necessary, as soon as the 
heated condition of the body is overcome. The dash- 
ing of cold water over the chest and face is a useful 
means of encouraging a return of the suspended 
breathing, and is practiced in asphyxia from other 
causes (page 14). The ready methods of page 13, 
however, had better be relied on for this purpose. 

Medicines, it will be seen, are of little value in this 
malady. A stimulant, however, may be useful, and 
the best stimulant in all such cases, if it can be ob- 
tained, is the aromatic spirits of ammonia, fifteen or 
twenty drops in a tablespoonful of water, which may 
be given every few minutes, until three or four doses 
have been taken. 

Prevention. — During very hot weather all use 
whatever of malt, fermented, or distilled drinks 
should be abstained from. Not only do they favor, 
in a general way, a condition of the system in many 
respects similar to that which leads to sunstroke, but 
they deaden sensibility at the very time that it ought 

(IBS'* Insure in The Mutual Life Insurance Co. op New York.) 



SUNSTROKE. 65 

to be on the alert, and the person is less able to detect 
slight changes in his feelings, which otherwise might 
have served as useful guides. 

Everything in any way calculated to impair the 
strength should be avoided. Sleep is a most wonder- 
ful restorer of strength, and the want of it is often 
caused by a badly-assorted late meal of the evening 
before. Defective ventilation leads to a condition of 
affairs favorable to the malady under consideration. 
Every night a bath should be taken ; but as this is not 
always possible in every house, the entire body should 
be washed off each night before lying down. Labor- 
ing men who work in the sun have no excuse for 
neglecting this, for water costs nothing, and three 
minutes' time is all that is required. 

Drinking large quantities of cold water, merely be- 
cause it is cold, should be avoided immediately be- 
fore, during and after meals. The debility resulting 
from the heat weakens the digestive powers, and water 
unnecessarily used to excess at the times named tends preventive 
still further to retard the digestion of the food by weak- measures 
ening the solvent action of the secretions of the stom- (continued), 
ach. 

In other words, if there is a time above all others, 
the year around, when precaution for the preservation 
of health is required, it is during the hot months of 
summer. 

Loosely fitting light garments should be worn, if 
possible. Particular attention should be given the 
head. It should be protected from the heat of the sun, 
and at the same time the covering worn should favor 
the circulation of a free current of air over the scalp. 
A straw hat of loose texture, with a lining to the crown 
which can be kept constantly wet, ought to be worn ; 

(^"Insure in The Mutual Life Insurance Co. op New York.) 



66 FROST BITE. 

and if it has brim enough to protect the neck, and 
even the shoulders, the wearer is more fortunate than 
other people. 

While attention should always be paid to these 
things in hot weather, it is particularly necessary, 
if any symptom be observed on some special day, that 
the greatest care should be taken not to let it extend 
into an attack of sunstroke. Discontinuance of work 
until the symptoms disappear, in such a case, would 
seem to be the only course to be pursued. 

It is said that persons who have once suffered from 
siunstroke, for a long time after are unable to bear 
much exposure to the heat without a recurrence of 
the symptoms of the malady. 

FROST BITE. 

Exposure to severe cold often leaves the fingers and 
toes, nose and ears and lips, more or less frozen. This 
Frostbite condition, short of absolute death of the part, is 
where termed frost bite. It will be observed that the portions 

located. of the body just enumerated are those most exposed, 

in area, to the influence of the cold, and are furthest 
situated from the heart; and it will, perhaps, be un- 
necessary to remark that persons who are debilitated 
are more apt to suffer with the same amount of ex- 
posure than the robust. 

When the circulation of any part begins to suc- 
cumb to the influence of the cold, it becomes puffy, 
bluish and smarting. This is because the blood 
Symptoms. moves more slowly than natural through the vessels 
exposed near the surface. Soon this blueness dis- 
appears, and the part becomes pallid, as if the influence 
of the cold had contracted the vessels to an extent in- 
compatible with the passage of blood through them. 

(OPliisure in The Mutual Life Insurance Co. op New York.) 



FROST BITE. 87 

The pain at this point ceases ; indeed, until the sufferer 
meets a friend, he often does not know of his mishap. 
At this stage, the injury has become so great that, 
unless proper means are taken to restore circulation, 
there ensues complete death of the part, which in due 
time sloughs away, and is detached from the living 
tissue. 

What takes place in a part of the body may take 
place in the whole of it, and then the person becomes 
"frozen to death." The blood of the extremities being Kenera j 
gradually forced from them, under the continued sub- freezing, 
jection to the cold, is driven inward upon the larger 
blood-vessels, heart, lungs and brain. There is in- 
creasing difficulty in breathing, owing to the engorged 
state of the chest, and, what should always be remem- 
bered by one so exposed to cold, an unconquerable de- 
sire to sleep. To sleep then is to die. If the person 
exihibits such a symptom, he must, by all means, be 
kept constantly moving. 

Treatment. — Persons exposed as described, must be 
treated promptly, and one thing should never be Treatment of 
lost sight of, that is, to keep the frozen person general 
away from the heat. A person taken up insensi- freezing, 
ble, or nearly so, from exposure to the cold, should 
be taken into a cold room and his clothing re- 
moved, and be thoroughly rubbed with snow, or 
with cloths wrung out with ice-water. The fric- 
tion to every part of the body, particularly the ex- 
tremities, must be continued for some time, until 
signs of returning animation appear. When the frozen 
limbs show signs of life, the person should be carefully 
dried ; put in a cold bed in a cold room ; artificial res- 
piration used until the natural is established; then 
brandy given, also ginger-tea and beef-tea. Usually, 

(2^" Insure in The Mutuax. Lifb Insurance Co. op New Yobk.j 



68 



FROST BITE — CHILBLAIN. 



Treatment of 
frost bite. 



Chilblain, 
symptoms. 



Treatment. 



by this time medical advice will have been secured to 
direct further treatment. Should this not be the case, 
do not forget that the patient is to be brought by 
degrees into rather warmer air ; and lest in some part 
there might still be defective circulation, he should 
be kept away from exposure to the heat of the fire. 

Milder degrees of the same condition, as suspension 
of life in the ear, nose, finger, or toe, from exposure to 
cold, must be treated with the same general directions 
in view. The part should be kept away from the heat, 
and rubbed with handfuls of snow, or with towels 
dipped in cold water, until circulation appears re-estab- 
lished. Exposure of the part to the heat before, as 
we might say, it has been rebuilt, is apt to be followed 
by sloughing. 

CHILBLAIN. 

As the name implies, this occurs when the circula- 
tion of the part has become chilled — disturbed — not 
destroyed. It is generally attended with much itching, 
tingling and smarting, and is usually found in the toes, 
outside edge of the feet, just where the toe emerges, or 
in the heel. Sometimes, in persons of debilitated state 
of health, the hands suffer. These symptoms are par- 
ticularly annoying just after lying down in bed. 

The most useful thing for these annoying symp- 
toms is to keep away from the fire, and every 
night, before retiring, bathe the feet in cold water, 
or rub them with snow. Thev should then be 
well dried with a soft towel. After this, the appli- 
cation of the ordinary compound resin ointment 
of the apothecaries is often of use in stimulating the 
circulation through the part. The efficiency of this 
ointment for the special purpose can be increased by 
asking the apothecary to add to an ounce of it a 

(B3T Insure in The Mutual Life Insurance Co. of New York.) 



CONVTJLSIONS. 69 

couple of drams of the oil of turpentine. It may be 
remarked, that persons who suffer in winter from cold 
feet are often benefited to a surprising degree by bath- 
ing them at night, before retiring, in cold water. Such 
persons should always keep their feet away from the 
fire. 

CONVULSIONS. 

Convulsions, or "fits," as they are often called, are 
a frequent cause of alarm in the streets, or at public 
assemblages. In the decided majority of instances, the 
convulsions may be safely presumed to be epileptic ; so, 
unless otherwise specified, the remarks here made epilept j c 
apply to that form. Ordinary fainting may be con- 
founded with it; but here the face is pale, the person 
perfectly still, and there is no perceptible breathing. 
Besides, in fainting there are no convulsive move- 
ments. 

Frequently the epileptic seizure is ushered in with 
a peculiar sharp cry, as the person falls over. This 
does not always occur, but when it does, there can 
be no doubt, if it is a convulsion at all, that it is 
epileptic. There is frothing of the mouth, sometimes 
tinged with blood from the tongue or a fold of the 
lips having been caught between the teeth at the 
moment the spasm commenced in the muscles of the 
jaws. Sometimes there are general convulsive move- 
ments of the whole body ; often of parts of it only. At 
first the face is pale, but usually, in the course of a few 
moments, it becomes livid, except around the mouth, 
which often continues pale, in strong contrast with the 
color of the rest of the face. As a general rule, it may 
be said that the convulsive feature of attack does not 
last much longer than four or five minutes, although 
to bystanders the time naturally seems longer. Then 

(J3~ Insure in The Mutual Life Ixsuraxce Co. op 1\kw Yokk.) 



Symptoms. 



70 



CONVULSIONS. 



Treatment 
during the 
convulsion. 



the person opens his eyes with a certain degree of in- 
telligence, or revives enough to speak ; and it is usually 
at this point of the attack that the most must be done. 
Sometimes there is nothing beyond it, and the individ- 
ual gets up, hurriedly puts on his hat, and walks 
off, apparently the least concerned person of all. 

If this happy termination does not take place, the 
brief semi-conscious interval gives way to a heavy 
stupor, varying in duration from thirty minutes to 
three or even six hours. 

Treatment. — In epileptic convulsions, there is usu- 
ally nothing to be done. Ignorant people on such oc- 
casions are apt, upon the general plea, "If you do not 
know what to do, do something," to insist upon "open- 
ing the hands," as the phrase is, saying that the pa- 
tient will be better as soon as they can do it. The 
truth is, they cannot do it until the patient is better. 
All interference of this kind is hurtful, and no good can 
come of it. All rude efforts aggravate the trouble, 
perhaps by exhausting still further the muscular 
strength of the patient. 

All that can be done is to keep the person from in- 
juring himself or hurting others during the violent 
convulsive movements, by removing him to some 
clear space, where there is nothing to strike against. 
Do not attempt to hold the limbs, but loosen every-, 
thing about the throat and chest. A folded handker- 
chief or a cork can be slipped between the teeth, so as 
to prevent biting of the tongue. Care should be taken 
that it does not interfere with breathing. 

Wait a few minutes for the convulsive movements 
to cease, and the semi-conscious state to appear. As 
said above, it will soon be seen. Then, if the person 
is a stranger, get his name and residence, if possible, 

(J£P*Insure in The Mutual Lifb Insurance Co. op New Tobk.) 



CONVULSIONS. 71 

with such other knowledge as may be useful. In 
the meanwhile, keep the crowd away. This is a 
very important measure of assistance in convul- 
sions, as in every other emergency. By this it is 
not meant that no one must bend over the victim, but 
that a perfectly free space of at least ten feet on each 
side should be kept, with none in it but the one or two 
persons immediately assisting him. 

Thirty drops of the aromatic spirits of ammonia, in 
a teaspoonful of water, may be given to the patient, as 
it is thought by many physicians to lighten and shorten Treatment 
the later stage of stupor. The spasmodic condition a f te r the 
of the muscles of the jaws, by means of a little gentle convulsion, 
dexterity, can usually be sufficiently overcome to per- 
mit of the introduction of the restorative into the 
mouth by the assistance of another spoon or a piece 
of smooth stick. After getting the liquid into the 
mouth, press down the base of the tongue, and the 
mixture will readily run down the throat. As much of 
it will necessarily be lost during the operation, double 
the quantity may be prepared for use. If more than 
the thirty drops should be given, no trouble from it 
need be feared. 

If the name and residence have been secured, the 
friends of the person can be notified. If not, he should 
be taken to some place of security until consciousness 
returns. 

Persons liable to epileptic convulsions should never 
be permitted to go from the house without a strip 
containing the name, residence and disease, attached E P lle P tlcs 
inside of the coat, where it will at once be seen upon , 

r always carry 

unbottonmg the coat over the chest. A reference on their name ' 
it to a memorandum in some pocket containing a and address, 
suggestion as to the duration of the attack, and to 

0"lnsnre in The Mutual Lits I>suka>ck Co. op New York.) 



72 



CONVULSIONS — DIARRHOEA. 



Apoplectic 
convulsions. 



Hysterical 
convulsions. 



some remedy which assists restoration, would often 
materially add to the comfort and advantage of the 
afflicted person. 

Other convulsions are apoplectic. These are com- 
paratively uncommon. As a rule, little can be done by 
bystanders, further than loosening everything about 
the neck. This should be done in all convulsions. 

The convulsions known as hysterical are usually 
found in young women who are not very strong. 
Until assistance comes, act as directed in epileptic con- 
vulsions. The distinction between them cannot be- 
expressed to unprofessional persons. 



Diarrhoea, 
causes. 



Symptoms. 



DIARRHEA. 

This very common summer complaint may be due 
to several causes. It may be caused by simple ex- 
cess of food, especially fruits and vegetables; or by 
improper food, such as these same things, when un- 
ripe; or by food that has begun to decompose, even 
though so slightly as not to be detected by the senses ; 
or by changes in the weather, the so-called catching 
cold, although this latter is more of a predisposing 
cause than an immediate one; or by changes in the 
drinking water. 

The symptoms vary much in severity, cases ranging 
from two or three movements a day to thirty or 
forty. The movements may be accompanied by pros- 
tration, by no pain or by considerable. The cases 
range from the harmless attacks, which no one pays 
much attention to, up to the border line of dysentery. 

In all cases the condition exists that some unsuit- 
able material is present in the intestines, that the latter 
are trying to get rid of it, and are already irritated by 

flSTInsure in The Mutual Life Insueance Co. op New Yobs.) 



DIARRHOEA. 73 

it. We have then two indications ; First to remove 
this offensive matter. Second, to allay the irritation 
caused by it. For the first there is nothing better 
than castor-oil, a tablespoonful or two of which should 
be taken at once by an adult. A little less may be 
given to children, but they stand it very well. If this 
cannot be had, we can give a few grains of calomel 
or a few teaspoonfuls of Epsom or Glauber's salts in 
water ; but these are not as good as castor-oil. 

To allay the irritation present in the intestines, we 
can apply hot cloths to the abdomen, and these are 
made more efficient by adding a few drops of turpen- 
tine to the hot water in which they are dipped. A 
large mustard plaster is also good. This should be 
quite weak — one part mustard to ten parts of flour — 
and should be made with cold water. These local ap- 
plications can be made as soon as we have given one 
of the purgatives above mentioned. In three or four 
hours more we can give some medicine, which will 
soothe the intestines. A simple but effective one is 
blackberry brandy with bismuth subnitrate, a table- 
spoonful of the former and an even teaspoonful of the 
latter every two or three hours. If much pain is 
present, we can add five drops of laudanum to each 
dose. Care should be taken that the diet is very sim- 
ple for the next few days, consisting mainly of milk, 
eggs and toast. 

If blackberry brandy cannot be had, any other mild 
astringent can be used. Even Pond's Extract will be 
of service. The bismuth will make the movements 
black, but that should not alarm any one. In very 
mild cases the castor-oil alone may be enough to cure 
the trouble. If the movements are at all frequent, it 
is better for the patient to remain in bed. 

($3F"Insure in The Mutual Life Ixsusaxcb Co. op New Yokk.) 



Treatment 



74 



DYSENTERY—CHOLERA. 



DYSENTERY. 



Dysentery. 



When the movements are quite frequent, contain- 
ing blood or mucus, and are accompanied and fol- 
lowed by griping pain, the condition known as dys- 
entery is present. This is much more serious than 
diarrhoea, and every means should be taken to obtain 
the advice of a physician. If this cannot be had the 
measures indicated under ''Diarrhoea" should be car- 
ried out, and will oftentimes succeed. They must 
be done thoroughly, and if the attack lasts longer than 
two days, it will be necessary to give the castor-oil 
every second day. If blackberry brandy is not used, it 
will be necessary to give some other stimulant — a 
tablespoonful of brandy or whisky in water or milk 
every four or five hours. 



CHOLERA MORBUS, 



Cholera 
morbus, 
causes. 



Symptoms. 



This disease is due in most, if not all, cases to the 
eating of some poisonous food. This may be poison- 
ous naturally, as in the case of some mushrooms, or 
it may be so from beginning decomposition. De- 
composition causes in many foods, even before it can 
be detected by the senses, the formation of certain 
active principles called ptomaines, and these are often 
very irritating to the stomach and intestines. 

The symptoms are frequent retching and vomiting, 
profuse diarrhoea and marked prostration and weak- 
ness. These symptoms last only a few hours, as a 
rule, but they are sometimes fatal. 

A physician is nearly always required, as usually the 
medicines have to be given hypodermically, owing to 
the vomiting. Nothing should be given by mouth at 

(.ZW Insure in The Mutual Life Insurance Co. op New Yoek.) 



CHOLERA. 75 

first — not even water or ice. Hot cloths or a mustard 
plaster may be applied to the abdomen, and the ex- _ 
tremities can be rubbed to relieve the cramps which 
are often present. If no doctor can be had, five drops 
of laudanum without any water can be placed on the 
tongue, and repeated every fifteen minutes until five 
or six doses have been taken. Some will be doubtless 
vomited, but enough may be absorbed to have some 
effect. After the vomiting has ceased for two hours, 
teaspoonful doses of brandy may be given every fifteen 
or twenty minutes. If any diarrhoea is present the 
next day, it should be treated. The diet should be 
very simple for a few days. 

EPIDEMIC CHOLERA. 

This is a very severe and fatal disease, spreading 
over the world in epidemics which regularly begin in 
Asia. From this circumstance it is often called Asiatic E P ldemic 

cholera. 

cholera. It is caused by certain germs, which are usu- 
ally taken in with the drinking water, and then develop 
in the intestines. 

The symptoms are very much like cholera morbus, 
but much more fatal, one or two out of every three 
attacked dying. 

Little can be done during the attack except by a 
doctor. If he cannot be obtained, follow out the same 
treatment as laid down in cholera morbus. During an Treatment - 
epidemic of cholera, every diarrhoea, no matter how 
trifling, should be treated promptly and thoroughly. 
As a preventive measure during an epidemic, all the 
drinking water, and the water used in preparing the 
food and washing the dishes, should be well boiled. 
None of the ordinary filters are of any use. 

(^"Insure in Ths Mutual Lira Insurance Co. op Kbw York.) 



76 



VOMITING — MALARIA. 



Treatment of 
vomiting. 



TO CHECK VOMITING. 

If due to mere irritability of the stomach or nervous 
system, the aromatic spirits of ammonia, in twenty- 
drop doses in ice-water, every few minutes, iced min- 
eral-water, iced champagne, thirty-drop doses of 
brandy, a mustard-plaster, cayenne-pepper plaster, 
broken ice in a bladder to the stomach, or opposite, 
over the spine, are all useful. This last often suc- 
ceeds where other things fail. 

Sometimes the vomiting is a proper effort to get 
something out of the stomach that ought not to be 
there. If this is known to be the case, assist it with 
a solution of salt and water, or pulverized ipecac- 
uanha. 



Malaria, 
cause of. 



Varieties. 



MALARIA. 

This disease is now known to be due to a living 
germ called the plasmodium malarise. The Plas- 
modium obtains entrance to the blood from the drink- 
ing water, or possibly is injected through the skin 
by mosquitoes. There are several species of this or- 
ganism, and each gives rise to a distinct type of the 
disease. 

The symptoms of the disease are so well known and 
usually so easily recognized that we will not describe 
them. 

The most common variety in this country is inter- 
mittent fever, also called "chills and fever" and "fever 
and ague." In this there is a distinct interval between 
the chills during which the patient feels comparatively 
well. The chills and fever usually occur every other 
day, and then we speak of it as the tertian type; or 
every day, being then called quotidian ; or every third 

({reinsure in The Mutual Life Insurance Co. op New York.) 



MALARIA. 77 

day, then being called quartan. Or the symptoms in- 
cluding the fever may persist without intermission, 
and then we speak of it as continuous or remittent 
malarial fever. Or the disease may pass into a chronic 
state, without chill or fever, which is commonly 
known as "dumb ague." There is also the very severe 
form known as pernicious fever. This usually begins 
as ordinary chills and fever, but after one or two at- 
tacks the symptoms get very much worse in the next 
one, the patient becomes delirious, then stupid and 
unconscious, and dies in a few hours. Besides these 
varieties there are other rare forms, too numerous to 
mention. 

The treatment can be summed up in one word — 
quinine. This is best used in the form of bisulphate, 
which is more soluble and less irritating than the 
common sulphate. It is well to precede the adminis- 
tration of this by a dose of calomel, five or ten grains, 
to relieve the congestion of the liver, which is often 
present. Then take quinine, ten grains three times 
a day, until three days after the last chill. The dose 
can now be reduced to five grains three times daily 
until the seventh day after the last chill. Malaria has 
a distinct tendency to reappear on the seventh day, 
and for this reason it is a good plan to increase the 
dose on that day to ten grains three times. If this 
point is safely passed, quinine should still be taken for 
a week, one dose of five grains daily. In some cases 
quinine seems to lose its efficacy. In these Warburg's 
Tincture, which is a mixture of quinine, with aloes and 
aromatics, is of great service. A tablespoonful should 
be taken each morning, fasting. In other cases, 
Clark's Powder will prove of value. This consists of 
quinine, ten grains ; capsicum, three grains, and pow- 



Treatment. 



(3T"Insure iu The Mutual Life Insurance Co. op New YodK.) 



Preventive 
measures. 



78 MALARIA. 

dered opium, one grain. One dose should be taken 
about four hours before the expected chill, and small 
doses of quinine during the intervals. If quinine 
causes much headache or ringing in the ears, this can 
be largely overcome by taking bromide of sodium 
or potassium, grain for grain, with each dose of qui- 
nine. 

To prevent the development of malaria certain pre- 
cautions can be taken, which are of value. One should 
not go out after sunset, nor near freshly plowed land. 
The home should not be in a hollow and the bedroom 
should be on the second floor, or higher. A cup of 
strong coffee before getting up is also of service. The 
most efficient preventive, however, is a small dose of 
quinine, say two grains, every morning on arising. 
This can be kept up for a long time with benefit 
and without harm. 



(E2P~ Insure In The Mutual Life Insurance Co. op New Yoek.) 



SECTION III. 



POISONS 



The effect of the accidental administration of 
poison may be greatly mitigated by a policy in The 
Mutual Life Insurance Company of New York. 



POISONS. 81 



Definition of 
a poison. 



POISONS. 

Under this term people are inclined to place only 
those things which, if taken internally, produce death. 
Physicians, however, consider it merely a relative term, 
and call anything a poison that does more harm than 
good to the body. A little of a good thing may be 
useful, but, beyond the point of usefulness, may be 
injurious. An exaggerated injury from the same 
cause may well be termed a poison. There is not a 
single poison in the entire list, which, in proper quanti- 
ties, and under favorable circumstances, may not be 
used with advantage to the human body; and on 
the other hand there is scarcely a single thing in 
ordinary use, which if indulged in beyond the require- 
ments of the body or its ability to properly dispose of 
it, may not be followed by symptoms of derangement 
of the economy, and in the above qualified sense is 
not miscalled, if termed a poison. 

In the majority of cases, the poison is introduced 
into the body through the stomach and as soon as 
swallowed may commence destructive action upon the action, 
mouth, throat, or stomach, as in the cases of acids, 
alkalies, arsenic, phosphorus, etc. While some sub- 
stances act in this way, others pass from the stomach 
through the mucous membrane without injuring it in- 
to the blood and are carried by it to the brain and 
other portions of the nervous system, where the really 
injurious action begins, overpowering them so that 
the breathing and action of the heart are not kept up. 
To this class of poisons belong alcohol, aconite, bella- 
donna, opium, strychnia, etc. 

E^~ Insure in The Motpal Lifb In9pbancb Co. op Nkw York.) 



Mode of 



Treatment 
in general. 



82 TREATMENT OF POISONING. 

A knowledge of the mode of action of a sub- 
stance will, therefore, of itself suggest an antidote or 
remedy. If an alkali has been taken, an acid will 
neutralize it, converting it into a compound less hurt- 
ful. The new compound is, perhaps, injurious, but not 
so active, and can be removed from the stomach some- 
what at leisure. On the other hand, if an acid has 
been taken, an alkali would naturally suggest itself 
as an antidote. 

Some poisonous substances cannot be neutralized 
by any convenient article, and must be removed from 
their lodging-place as soon as possible, and their ef- 
fects counteracted. 

If the agent does not act upon the stomach directly, 
but upon the brain and nervous system, reaching it 
through the blood, a recollection of what was said 
when certain gases have been inhaled will meet the 
case. Artificial respiration would, of course, be re- 
sorted to. This should continue until enough of the 
poison in the blood has been eliminated by the natural 
processes constantly going on in the body to permit 
the brain and nervous system to resume one of their 
old duties, that of attending to the respiration and cir- 
culation of the blood. 

As few persons have the necessary knowledge of the 
different poisons, each of these substances will be 
spoken of somewhat in detail, and alphabetically ar- 
ranged, so that, in case of need, immediate reference 
can be made to the particular substance supposed 
to have been taken. 

It should never be forgotten that the substance 
swallowed as a poison must be considered in its action 
as divided into two parts : that portion which has al- 
ready acted upon the mucous membrane (lining) of the 

(Sty Insure in Thr Mutual Lipb Insoranck Oo or Nktt Yobk,; 



TREATMENT OF POISONING. 83 

throat and stomach, or which has already passed from 
the stomach into the blood ; and that portion that is in 
the stomach and yet to be disposed of. 

It is the latter portion, perhaps, in most instances, 
we are called upon to first deal with, and evacuation 
of the stomach must be effected with the least possi- 
ble loss of time. This is done with the stomach- stomach- 
pump and by emetics. No directions for poisons pump, 
are complete without reference to the stomach- 
pump. With people who know nothing about the 
matter, it is very popular. The writer knows of 
but one physician among all his acquaintances who 
professes to keep one, and unless this particular 
instrument differs from all other complicated in- 
struments rarely used, he does not believe the 
owner of it could get it to work in an emergency, 
if he wished. Not a single apothecary, as far as 
he knows, keeps one, and a non-professional person 
could not use a stomach-pump with success if he had 
a dozen of them at his command. A siphon stomach- 
tube is of much value for emptying the stomach, but 
it can only be used successfully by a physician. 

EMETICS. 

For the purpose of rapidly emptying the stomach 
in the majority of cases, before the arrival of a physi- Emetics. 
cian, and after it as well, nothing equals an emetic, 
The most easily obtained is usually the best. There 
are few places where these things cannot be had: 
Ground mustard, common salt, and warm water. 

Take a tablespoonful of ground mustard and mix 
with a tumbler of water to about the consistence of 
milk. Give the person one-fourth of it at once. Then Mustard, 
follow with a cup of warm water. In about a minute, 

(>3T Insure Sn The Mutual Life Isideaxck Co. of Krw Torx.) 



84 



EMETICS IN POISONING. 



Common 
salt. 



Warm water. 



give the person the same quantity again, followed 
by the warm water. If vomiting does not take place, 
continue giving until it does, letting a minute or so 
elapse after each dose. Plentiful draughts of tepid 
water materially assist the action of an emetic, and 
the free use of it should, therefore, not be omitted. 
Mustard is not only useful as an emetic, easily ob- 
tained, and as readily given as anything else, but it is 
stimulating in character. This feature gives it a pe- 
culiar value in most cases where an emetic is de- 
manded, for a stimulant is often needed at the same 
time. The amount of stimulation derived from mus- 
tard is not always enough, but it is of some assistance 
in this direction. 

Common salt is even easier to obtain than ground 
mustard, and is as certain in its action. A teacupful 
of water, with as much salt dissolved as the water will 
hold, is given every minute or so, until vomiting oc- 
curs. 

Warm water, given cup after cup, is a safe emetic; 
but as the above-mentioned articles are so easily ob- 
tained, it is rarely used alone. Usually it is given to 
assist the action of the other substances, on the prin- 
ciple, perhaps, that a distended stomach is more easily 
emptied than one with little in it. After vomiting has 
occurred, frequent draughts of warm water are often 
given to cleanse out the stomach. In many instances 
warm milk, gum-arabic water, flour and water, the 
white of an egg in a teacup of tepid water, and such 
substances, are given instead, with the expectation 
that their gummy viscid properties may enable them to 
entangle and detach particles of the poison adherent 
to the mucous membrane (lining) of the stomach. In 



($W Insure in The Mutual Life Insurance Co. op New York.) 



EMETICS IN POISONING. 85 

addition, they are soothing to the irritated condition of 
the parts. 

Tickling the inside of the throat by the finger, or Tkklin t h 
with the tip of a feather, will in many instances suffice throat. 
to induce vomiting. Frequently, after an emetic 
has been given, this procedure is used to hasten its 
action. 

Sulphate of zinc is another valuable emetic often 
found in private houses. As much as will lie heaped u p 
up on a twenty-five cent piece is twenty grains, 
which is a dose, when dissolved in water. This quan- 
tity should be given at a single draught, followed 
by a cup of tepid water, and repeated every three 
minutes, until three or four doses have been taken, 
or vomiting occurs. If there is none in the house, 
send to the nearest apothecary for sixty grains of the 
sulphate of zinc (" white vitriol"). Empty into half a 
pint of tepid water. Stir rapidly with a stick, and it 
will soon dissolve. One-third of this half-pint contains, 
of course, twenty grains of the sixty put in, and that 
quantity should be given at a single draught, followed, 
as all emetics should be, by draughts of tepid water. 
In a few minutes repeat, as directed about mustard, 
unless profuse vomiting takes place. 

Pulverized ipecacuanha is another valuable emetic, 
particularly for children. It can be obtained of any 
apothecary. Sixty grains (one dram) of it may be 
requested. It is a ground root, and does not dissolve Ipecac, 
in water, but mixes with it, like ground mustard. One- 
third of the sixty grains, which is twenty grains (as 
much in bulk as will heap up on a silver quarter) may 
be given, mixed with a small teacup of tepid water, 
followed by a draught of tepid water. In a few mo- 
ments, if vomiting does not occur, give another third, 

(^"Insure in Thb Mutual Lifb Insurance Co. op New York.) 



86 



EMETICS IN POISONING. 



Swallowing 
should be 
forced, if 
necessary. 



Vomiting 
should be 
repeated. 



as you gave the first, to be followed in sixty seconds 
more by the last. 

A good deal of trouble is often experienced in get- 
ting the person to swallow. This may be due to in- 
sensibility, fright or stubbornness. The thumb of 
each hand may be slipped in outside and close against 
the teeth, along the line of junction, until the spot is 
reached behind which there are no teeth. Then 
through that vacant space slip the tips of the thumbs 
in between the jaws, when a separation can be readily 
effected. The thumbs should be kept there, for the 
patient cannot bite the attendant while his fingers 
are in such a position, and the handle of a strong 
iron or silver spoon or piece of smooth stick be thrust 
back far enough to forcibly depress the tongue. The 
liquid can then be poured down the throat, if the per- 
son is lying on his back. At first it will fill up the 
space at the base of the tongue, but a little more de- 
pression of the tongue by the spoon or stick will cause 
it to run down the throat. There need be no fear of 
the fluid getting into the windpipe, for a very sensitive 
valve over the entrance of the trachea (windpipe) am- 
ply protects it. 

The first vomiting, as said before, does not neces- 
sarily clear the stomach of its contents. Much of the 
poison may remain adherent to the mucous membrane, 
requiring frequent washings for detachment and re- 
moval. After the first vomiting, there is usually little 
trouble in keeping it up, by simply giving plenty of 
tepid water. Warm water alone, as said before, is 
often an emetic, and when none of the substances 
mentioned can be had, must be wholly relied upon for 
the purpose. 



($W Insure in Tile Mutual Life Insqeance Co. op New Yobk.) 



EMETICS IN POISONING. 87 

Before the action of an emetic can begin, a portion Bowels 
of the poison usually escapes from the stomach into should be 
the bowels. No vomiting can affect it ; so, after the purged, 
contents of the stomach have been removed by the 
action of the emetic, it is always well, to administer 
a quick-acting purgative, such as Epsom salts, two 
teaspoonfuls in half a glass of water. Follow this in 
fifteen minutes by good quantities of milk, which, 
passing down, engages the activity of the poison. 
Flour and water will answer, but better, perhaps, is 
the white of eggs mixed with water. 

Now we will suppose all the poison has been re- After-treat- 
moved by the above efforts from the stomach. The ment. 
next thing is the removal of the consequences of that 
portion of the poison which has already commenced 
its work. If the mucous membrane has been injured, 
it should have rest from its usual work — digesting 
food — and be treated by suitable soothing applications, 
as barley water, gum-arabic water, and such things. 
This should follow where the poisoning is due to any 
of the mineral poisons. 

POISONING BY MUSHROOMS. 

Persons not well acquainted with the difference be- Poisoning by 
tween the poisonous and edible mushrooms had better mushrooms, 
buy them of those who are, or go without. There are 
distinctions between them, but they are not of such a 
character as can be made evident in this work. 

When poisoning from eating mushrooms does take 
place, the contents of the stomach should at once be 
evacuated by an emetic. (See page 83.) After vomit- 
ing has commenced, it should be promoted by 

(t3T Insure in The Mutual Life Insurance Co. op New York.) 



88 MUSHROOMS — MEATS. 

draughts of warm water, barley water, but particularly 
by drinking copiously of warm milk and water, to 
which sugar has been added. 

What has passed along into the bowels should be 
hurried out as fast as possible, by some cathartic, be- 
fore further absorption into the blood can take place. 

If there is much prostration, some easily pro- 
cured stimulant might be useful, as the aromatic 
spirits of ammonia, or brandy. A very excellent 
antidote is tincture of belladonna, ten drops in a little 
water every hour until four or five doses have been 
taken. 

POISONOUS MEATS. 

Poisonous The eating of meat from diseased animals is often 

meats. followed by symptoms of a poisonous character. Ani- 

mals otherwise in perfect health, but which have been 
butchered and prepared for food after long and ex- 
haustive confinement, are unfit for eating. Not only 
is the meat of such animals lacking in nutritive char- 
acter, when compared with the meat of animals killed 
from the pasture without excitement, or after being kept 
until proper recovery from the effects of the journey 
to market, but it is much less savory, and shows a 
disposition to decompose much more readily. It 
has been estimated by competent authorities, 
that between the two kinds of meat there is, 
in a commercial sense alone, as far as nutriment 
is concerned, a difference of nearly 50 per cent, 
in favor of the meat of healthful animals, butch- 
ered after complete recovery from the excitement and 
fatigue of drive or carriage to market. The additional 
cost per pound of meat to cover the expenses of extra 

(XW Insure in The Mutual Life Insurance Co. op Nkw York.) 



POISONOUS MEAT — FISH. 89 

care and precaution before butchering, would amount 
to but a small fraction of the percentage named, leav- 
ing the rest of it a true profit to the consumer. 

The eating of this overdriven meat is sometimes fol- 
lowed by symptoms of irritation of the stomach and 
bowels ; but they can, in the ordinary sense of the 
word, scarcely be said to be of a poisonous character, 
however much the use of them may temporarily de- 
range the health. 

POISONOUS FISH. 

Several varieties of fish, at all seasons of the year, 
are reputed to be poisonous. These should, of course, 
always be let alone. Should they have been eaten by 
accident, the best treatment is that given under the 
head of "Poisoning by Mushrooms," page 87. 

Shellfish, at certain seasons of the year, after 
spawning, are considered poisonous ; at least, they are 
unhealthy. This process of nature is known to be 
very exhausting, and during it or just afterward, the 
individual is so reduced in vitality as to be unable to 
resist the ordinary tendency to decomposition. 

Oysters in hot weather are often unwholesome, per- 
haps from the causes suggested, or it may be that 
the collection of liquid secretion between the shell 
and the contained animal, in hot weather, is in a state 
favorable to putrefaction upon slight exposure to the 
air, and that the disagreeable symptoms often said to 
arise after partaking of this fish as food is due to this 
as much as anything else. 



Poisonous 
fish. 



(J^Tnsnre in Thr Mittuai, Life Insurance Co. of J« t kw Yohk.) 



90 



MINERAL POISONS. 



MINERAL POISONS. 

Alkalies, Alkaline Earths, Acids, Metals, Etc. 



ACIDS. 



Acids. 



The common acids, acetic, muriatic, nitric ("aqua 
fortis"), sulphuric ("oil of vitriol"), are highly cor- 
rosive in their action, unless largely diluted, and act 
with even greater rapidity when taken internally than 
when applied externally. They are as troublesome in 
this respect as concentrated alkalies. 

When taken, the acid should be neutralized, as far 
as possible, by giving some harmless alkali. Cook- 
ing-soda or saleratus, a teaspoonful of either, in half 
a glass of water, can be given every few minutes until 
several doses have been taken. Lime-water might be 
used for the same purpose, and aromatic spirits of 
ammonia, besides neutralizing the acid, would be of 
value as a stimulant. Common soap, from the alkali 
it contains, might be given. 



AMMONIA. 

The ordinary aqua ammoniae, sometimes known as 
"hartshorn/' acts on the mucous membrane of the 
Ammonia. stomach as we should expect it to do, knowing its 
effect upon the mucous membrane of the nostrils. 
When swallowed, it is a rapid corrosive poison. 
Owing to its pungency, it can scarcely be given by 
mistake in a state of purity. With olive oil, it forms 
the common "hartshorn liniment," and has thus been 
given internally. 

(jE^Insure In The Mutoai. Lifs Insurance Co. of Nkw Tobk.) 



MINERAL POISONS. 91 

A violently acting corrosive substance, like am- 
monia, leaves no time for emetics. It is an alkali, 
and the common dilute acid known as vinegar will 
neutralize it. Lemon-juice also would answer the 
purpose. 

Other concentrated alkalies, as lime, soda and pot- 
ash, act in the same manner as ammonia, and when 
taken internally must be combated in the same way, 
and with the same difficulties in view. 

ANTIMONY. 

This metal is rarely accessible in its purity. One 
of its salts, tartar emetic, or the wine of antimony 
(which is tartar emetic dissolved in wine), is the usual 
source of the poison. Vomiting is one of the most 
distressing and prominent symptoms of poisoning by 
this substance. Assisted by copious draughts of tepid 
water, sugar and water, flaxseed water, much of the 
poison in the stomach may be gotten out. Another 
symptom is great prostration. If a small quantity only 
is known to have been swallowed, a teaspoonful of 
paregoric in a little sweetened water may be divided 
into three portions, one of them being given every 
ten or fifteen minutes. It soothes the irritated and 
excited stomach. 

The antidote usually recommended is nut-galls, or 
oak-bark in powder. Half a dozen of the former, 
finely powdered, may be given, mixed with water. 
The active principle in each of these is what is called 
tannin, or tannic acid, now to be had of every apothe- 
cary and dyer. Ten grains of it (a teaspoonful — it is 
very light) in water will be equivalent to the nut-galls 
mentioned. A strong infusion of common green tea 

(.t&~ Insure in Thb Mutual Life Insubanck Co. of New Yobk. ) 



Antimony 



92 



MINERAL POISONS. 



contains enough tannin to make it useful as an anti- 
dote. An insoluble, and perhaps inert, tannate of 
antimony is formed. 

ARSENIC. 



Poisonous 
varieties of 
arsenic. 



Use of 
emetics. 



In some places this is called "ratsbane," and poison- 
ing often occurs from it. The yellow sulphuret of 
arsenic (orpiment), the red sulphuret of arsenic (real- 
gar), and the arsenite of copper (paris green), em- 
ployed in the arts have all been used internally with 
fatal effects. All these sources of poisoning by arsenic 
should be surrounded by every possible precaution to 
prevent them from being accidentally used. Many 
"fly-poisons" contain it, and what is used in medicine 
under the name of Fowler's Solution is a solution of 
arsenic. 

Arsenic acts as an irritant to the stomach and 
bowels, in many respects like antimony and its 
preparations. As soon as it becomes known that 
arsenic or any of its preparations has been swal- 
lowed in poisonous doses, the poison taken should 
be dislodged from the stomach, as far as pos- 
sible, by vomiting (see "Emetics," page 8s), assisted 
by the finger to the throat, or the feather part of a 
quill. Free drinking of milk, white of egg and 
water, or flour and water, should be encouraged. 
Not only do these things encourage vomiting and 
dilute the poison, but at the same time they tend to 
envelop the particles of the poison until the mass can 
be removed from the stomach. 

The antidote to arsenic is the freshly prepared hy- 
drated sesquioxide of iron. This can be had of any 

($W Insure in The Mutual Life Insurance Co. op New York.) 



MINERAL POISONS. 93 

apothecary in a few moments of time. It is quite The ant idote 
harmless in character, and may be given in almost and its 
any quantity. The iron, in this particular form, com- preparation, 
bines with the arsenic, forming a temporarily harm- 
less preparation. This newly formed compound 
should not be permitted to remain and be digested, 
but must be dislodged afterward by an emetic, which 
the bulk of the antidote favors. 

The hydrated sesquioxide can be made by almost 
any one in a few moments. Take a glass tumbler, 
or a graduated measure, pour in three or four 
tablespoonfuls (quantity not of much importance) 
of aqua ammonias, and then a tablespoonful 
or more of tincture of chloride of iron. Instead of 
the ammonia we may use a strong solution of cooking 
or washing soda, two or three teaspoonfuls dissolved 
in as many tablespoonfuls of water. 

A thick, dark, reddish precipitate, like brick-dust, 
is at once seen in the mixed liquids, which may be 
increased in quantity by gently stirring with a broom- 
splint. 

This precipitate is the sesquioxide, and it must 
be separated from the liquid by spreading a fine 
handkerchief or closely woven piece of muslin over a 
cup and pouring on the mixture. The liquid will 
run through, leaving the desired oxide of iron as a 
reddish-brown, jelly-like powder. To free it from any 
excess of either substance used in its formation, a 
half pint or so of tepid water should be poured on in 
a gentle stream to wash the precipitate. The washed 
precipitate is now ready for use. A teaspoonful of it 
may be given every few minutes. 

Calcined magnesia and pulverized charcoal have 
also been recommended as antidotes in poisoning by 

(t^- Insure in Thi Mctca! Life Iksceakck Co. of Net York.) 



94 



MINERAL POISONS. 



Baryta. 



arsenic, but of their value nothing can be said by the 
writer. 

BARYTA. 

This substance, largely used to adulterate certain 
paints, is sometimes accidentally swallowed in pois- 
onous doses. 

The antidote is water, acidulated to about the 
strength of lemonade with sulphuric acid. This con- 
verts the baryta into an insoluble compound, which 
must be dislodged from the stomach by an emetic. 
Epsom salt or Glauber's salt may be used instead of 
sulphuric acid. 

COPPER. 



Copper. 



Treatment 
of copper- 
poisoning. 



Poisoning from copper occurs most commonly 
through the careless use of utensils made of it. Most 
acids form soluble salts with copper; hence acids 
should never be used for cooking purposes in copper 
vessels. Many of the ordinary vegetables and fruits 
contain enough acid to form poisonous salts with the 
metal. Even sugar, from the ease with which solu- 
tions of it are changed into acids, should be cau- 
tiously used in contact with copper. When copper is 
mentioned it must be understood to include brass and 
other alloys into which copper enters as a necessary 
component. 

The stomach must at once be emptied by an emetic, 
and copious draughts of milk, or the white of eggs 
mixed with water. Carbonate of soda (the ordinary 
baking-soda or cooking-soda will answer) is said to be 
an antidote. As much as will lie heaped up on a 

flt^-Insure in The Mutual Life Insurance Co. of New York.) ' 



Iodine. 



Iron. 



MINERAL POISONS. 95 

silver quarter can be given every five minutes, in 
water, or in the other named liquids. Yellow prus- 
siate, or ferrocyanide, of potash is an efficient anti- 
dote, if it can be obtained pure. 

IODINE. 

The common tincture of iodine, used for external 
application, is the usual form of this poison. Starch, 
in water, is a mild antidote, and may be freely given 
until vomiting is secured by an emetic. 

IRON. 

The form usually taken is a solution of the sulphate 
of iron (copperas, green vitriol). Its action, like most 
of the poisons heretofore described, is that of an ir- 
ritant poison in the mucous membrane (lining) of 
the stomach and bowels. The antidote is carbonate 
of soda. 

LEAD. 



Poisoning by this substance usually is due to the Lead 
acetate of lead (sugar of lead). The carbonate of lead, 
the "white lead" of the painters, and the red oxide 
("red lead") are also sometimes swallowed in poison- 
ous doses. They all act as irritant poisons. 

The treatment of such cases consists in giving, as . fJt 

• 1 i 1 1 1 r Antidote 

an antidote, water acidulated to about the strength of f or i ea( j. 
lemonade with sulphuric acid ("oil of vitriol"). Sul- poisoning, 
phate of magnesia (Epsom salts), or the sulphate of 
soda (Glauber's salt), in water, are also good anti- 

(^~ Insure ia The MtrrtrAL Life Insueance Co. op Krw York.) 



96 



MINERAL POISONS. 



Chronic 
lead-poison- 
ing. 



dotes. After the antidote has been given in poisoning 
by lead, an emetic should be given. 

When lead is taken for some time in any of the 
soluble forms in small doses as when water has been 
kept in leaden vessels, or food kept or cooked in 
vessels "glazed" with lead, or the use of wines "sweet- 
ened" with the same metal, a peculiar train of symp- 
toms slowly follows, known as "lead-poisoning," or 
"painters' colic." All such possible sources of the 
introduction of lead into the system should be care- 
fully avoided, and as soon as the effects of the absorp- 
tion begin to be suspected, no time should be lost in 
consulting a physician. 



Lime. 



LIME. 

If accidentally administered, acts like ammonia. 
(Page 90.) 



MERCURY. 



The bichloride of mercury (corrosive sublimate), 
often used as a solution in houses for destroying 
vermin about beds, is a most active poison, when 
Mercury. taken internally. The red oxide of mercury (red 
precipitate) is another dangerous salt of the same 
metal. When swallowed, the white of eggs should 
at once be given, and often repeated. In the absence 
of this form of albumen, common milk can be used, or 
wheat flour beaten up with water. 

These salts of mercury not only irritate the stomach, 
but so rapidly inflame and destroy it that some writers 
discourage the use of emetics. If one can be given, 
however, before the poison has had time to produce 

flt^" Insure in The Mutual Life Insurance Co. op New York.) 



MINERAL POISONS. 97 

these extreme results, there can be no objection to its 
use. The continued administration of the antidotes is 
soon followed, as a rule, by free vomiting. 

PHOSPHORUS. 

This is probably not often taken in a state of purity. 
It is the active ingredient of most of the popular "Ex- osp orus * 
terminators" for rats and other vermin. These, as 
well as the ends of matches, have been taken with fatal 
results. Phosphorus acts as an irritant poison, inflam- 
ing the mucous membrane with which it comes in 
contact. 

A good antidote is sulphate of copper, five or ten Treatment 
grains of which can be given in water every fifteen f poisoning 
minutes until four doses have been taken. The sul- by phos- 
phate of copper is also a poison, but it is an active phorus. 
emetic, and all measures must be taken to promote 
vomiting. 

Another efficient antidote is turpentine, especially 
the old French variety. This can be given in fifteen- 
drop doses for five or six doses. 

As fat dissolves phosphorus, no form of food con- 
taining this should be given for a day or two, not 
even milk or eggs. 

POTASH. 

The caustic potash, in the form of common lye, or 
the concentrated lye, when swallowed, acts as other 
alkalies of the same general character. (See "Am- 
monia.") 

Nitrate of potash (saltpetre), in large doses, say 
half an ounce or more, taken internally, is followed 

({^"Insure in The Mutual Life Insurance Co op New York.) 



98 



MINERAL POISONS. 



Potash. 



by poisonous symptoms. There is pain, with heat 
in the stomach, vomiting, and purging of blood, great 
prostration, and other symptoms denoting the action 
of an irritant poison. 

No antidote is known. The treatment consists in 
rapidly evacuating the contents of the stomach by 
an emetic, and the free administrations of mucilagi- 
nous drinks, with some paregoric every little while, to 
allay the pain and irritation of the inflamed parts. 



SILVER. 



Silver. 



Antidote. 



The chief source of this poison is the nitrate of 
silver (lunar caustic), either solid or in solution. Its 
action as a "caustic" is well known, and it is in this 
manner that it acts upon the throat, stomach, etc., 
when taken internally, in solid stick or in solution. 

Nitrate of silver is the base of the numerous popular 
"hair dyes," and under this form has been accidentally 
and criminally taken. 

The antidote for the salts of silver is common salt, 
which immediately decomposes and destroys its activ- 
ity. The rapidity and completeness with which this 
is done is seen in the well-known domestic precau- 
tion of preventing solutions of silver employed as in- 
delible ink from staining, by immediately, while the 
spot is moist, touching it with salt and water. 



SODA. 



Soda. 



The same things are to be said about this alkali as 
about ammonia. 

(tSPlnsure in The Mutual Life Insurance Co. op New Yobk.) 



Zinc. 



MINERAL POISONS — VEGETABLE POISONS. 99 

TIN. 

Several compounds of this substance are used by Ti n# 
dyers, and have been used as poisons. They all act 
as irritant poisons. The treatment consists in copious 
draughts of milk, white of eggs in water, and flour 
and water. 

ZINC. 

The sulphate of zinc (white vitriol) might be termed 
poisonous in very large doses, were it not for the fact 
that it at once causes vomiting, and is brought up be- 
fore damage can be done. Hence it is regarded as one 
of our most valuable emetics. 



? VEGETABLE POISONS. 



Most of the class of poisons termed vegetable act 
as narcotics or as acro-narcotics. With some modi- 
fications, which will be mentioned in place, the treat- 
ment of all cases of narcotic poisoning is essentially 
the same; and a similar statement may be made in 
reference to the treatment of all cases of acro-narcotic 
poisoning. Hence, in speaking of the vegetable pois- 
on standing first in the alphabetical arrangement of 
these substances, the directions have been given under 
two heads : the nature of the acrid or irritating symp- 
toms and the treatment of the narcotic symptoms. In 
speaking of the other poisons, to save space and avoid 
repetition, the reader will be directed, for details of 
treatment, to some one of the substances, where direc- 
tions are given in full. 

(Z3T Insure in The Mutual Lifk Insurance Co. op New York.; 



Vegetable 
poisons. 



100 



VEGETABLE POISONS. 



ACONITE. 



Aconite. 



Treatment. 



Aconite is known under the names of "monkshood" 
and "wolfsbane." When swallowed in an overdose, 
it is rapidly followed by symptoms known as acro- 
narcotic; in other words, irritating to the throat and 
stomach, and narcotic to the brain and nervous sys- 
tem. The treatment naturally consists in getting out 
of the stomach all the poison there not already ab- 
sorbed into the blood. In acro-narcotic poisoning we 
have two reasons in view for such a course; first, to 
avoid, as much as possible, the irritating action of the 
poison on the mucous membrane which lines the stom- 
ach and its approaches, and, secondly, to prevent fur- 
ther absorption into the blood and narcotization of the 
brain and nervous system. 

The contents of the stomach are removed by tickling 
the throat and base of the tongue by the finger or a 
feather. An emetic (p. 83) of mustard and water, 
pulverized ipecacuanha, or sulphate of zinc, flaxseed 
tea, gum-arabic water, sugar and water, milk, white 
of egg, or things of this general character, should be 
freely given at the same time to protect the mucous 
membrane of the stomach from the irritating feature 
of the poison. 

As there is nothing known which will neutralize or 
destroy the poison in the blood acting through the 
brain and nervous system upon the important or- 
gans of breathing and circulation, the efforts for 
relief must consist in keeping up the respiration by 
artificial breathing (page 16) until the kidneys, skin 
and other organs have had time to eliminate the 
aconite. As this poison weakens the heart's action, we 
must freely use stimulants to counteract this effect, 

(lEP*Insure in The Mutual Life Insurance Co. op Nbw York.) 



VEGETABLE POISONS. 101 

such as brandy or whisky, aromatic spirits of am- 
monia and strons: coffee. 



ALCOHOL. 

Alcohol itself, or in the form of brandy, gin, rum, 
whisky, taken in large quantities, is followed by symp- 
toms of a violent poisonous character, and if relief 
is not at once obtained, death often ensues. The press 
reports instances not infrequently where children have 
swallowed alcohol left within their reach, and have 
died in consequence. 

When quantities sufficiently large to be followed 
by alarming symptoms have been taken, the contents 
of the stomach should be evacuated without delay, by f acut 
tickling the throat with a feather or the tip of the poisoning by 
finger, by an emetic, such as ground mustard and alcohol, 
water, pulverized ipecacuanha, or sulphate of zinc; or 
the stomach-pump may be used, if convenient. The 
vomiting should be assisted by copious draughts of 
warm water. 

The alcohol in the stomach having thus been dis- 
posed of, the portion which has passed from the stom- 
ach into the blood, and has been carried to the brain 
and to the rest of the nervous system, where its 
poisonous action is being exerted, next claims atten- 
tion, should symptoms appear to demand it. The ac- 
tion of alcohol and its preparations upon the brain and 
nervous system is seen under the common name of in- 
toxication. This may consist of mere stupor, or the 
brain and nervous system may be so completely over- 
come by the poison in the blood that the influence of 
these parts upon the muscular movements of the chest 
and the heart is no longer kept up, and death ensues 

XW Insure in The Mutual Iipe Insurance Co. op New York.) 



102 



VEGETABLE POISONS. 



Need of 
artificial 
respiration. 



from asphyxia, as described under that head. For this 
reason artificial respiration by the Sylvester method 
(described on p. 16) is sometimes indicated, and 
may be maintained for hours. Strong coffee is also of 
much value as a stimulant. The practice of walking 
the patient around has no merit unless he is able to 
use his legs himself, and if he can do that, there is 
no need for the exercise. Cold water douches also 
are not advisable, although they seem to do good 
for a few moments. The body and extremities should 
be kept warm by flannels and hot-water bottles. 



Belladonna. 



Atropine. 



BELLADONNA. 

Belladonna, or "deadly nightshade," has been intro- 
duced into our gardens as an ornamental flower, and 
poisoning sometimes occurs from eating the berries 
or leaves. Solutions of this or of its active principle, 
atropine, are used under various forms, and should 
never be left where they can be swallowed by mistake. 

Belladonna acts as a narcotic poison, like opium in 
many respects, only there is dilation, to a marked 
degree, of the pupil of the eye, and a peculiar redness 
or suffusion of the face, which are not seen in poison- 
ing by opium. The duskiness of the face is the symp- 
tom first observed by the physician. To discriminate 
between the two, it may be remarked, that stramo- 
nium (thorn apple, jimson weed) gives results closely 
of poisoning, resembling belladonna. Both of these substances — 
belladonna and stramonium — are attended, when swal- 
lowed in large doses, with a peculiar dryness of the 
throat and mouth, delirium, not accompanied at first 
with stupor, like opium, but with violent gestures, 
often violent laughter, and a peculiar disposition to 

(tW Insure in Ths Mutual Life Insurance Co. op New York.) 



Symptoms 



VEGETABLE POISONS. 103 

pick in the air, or at the clothing, for imaginary ob- 
jects. 

Treatment similar to that for aconite poisoning. 

BRYONY. 

The root of this plant, when swallowed in sufficient 
quantity, acts as an acrid, highly irritating poison. 
It is quite a common plant in Europe, but less seen 
in the United States. 

If taken in poisonous quantities, empty the stomach Bryony, 
as soon as possible; and, as in the case of all highly 
irritating poisons, this should be followed by free 
drinking of milk, flaxseed tea, white of egg and water, 
sugar and water, gum-arabic water, and similar things 

CAMPHOR. 

When taken in large doses, camphor acts as a narcotic 
poison. The contents of the stomach, in such cases, 
should be evacuated by an emetic (p. 83), followed 
by draughts of warm water, flaxseed tea, gum-arabic Camphor, 
water, milk and similar substances. The strong odor 
of camphor in the breath and perspiration, in case of 
poisoning, with narcotic symptoms, would naturally 
indicate the character of the poison. 

CARBOLIC ACID. 

This is frequently used as a poison nowadays. In 
some cases the action is so promptly fatal that there is 
no time for treatment. If possible, the stomach Carbolic 
should be evacuated, and large doses of any soluble aci ' 
sulphate, such as Epsom or Glauber's salts, should be 
given. As the prostration is apt to be great, these will 
have to be followed by stimulants. 

(fW Insure in Thb Mutual Life Insurance Co of New Yobe.) 



104 



VEGETABLE POISONS. 



Digitalis 



Treatment 
of digitalis- 
poisoning. 



DIGITALIS (" FOXGLOVE "). 

This beautiful plant of the garden, cultivated in this 
country for its flower, and used, in proper quantities, 
as a valuable medicine, is a poison of the narcotic 
class, with a disposition to overcome the portion of 
the nervous system controlling the action of the heart. 

The treatment is very similar to that for aconite 
poisoning, although in medicinal doses this drug is 
used to strengthen the heart's action. The reason for 
this apparent inconsistency is that in poisonous doses 
digitalis enormously over-stimulates the heart, so that 
in a little while it becomes very tired, and its action 
becomes weak. At this time, however, some other 
stimulant may still be effective until the poisonous 
influence of the digitalis has been eliminated. Great 
care must be taken to keep the patient flat in bed. 
Even sitting-up may be sufficient to stop entirely the 
already weakened heart. 



Dulcamara. 



DULCAMARA ("BITTER SWEET," "WOODY NIGHT- 
SHADE"). 

This well-known plant belongs to the narcotic class 
of poisons, with symptoms like those of belladonna 
and stramonium. The treatment is the same as for 
aconite. 



HYOSCYAMUS ("HENBANE"). 

This vegetable, made use of in medicine, if taken in- 
ternally in improper quantities, acts as a narcotic pois- 
Hyoscyamus on, like others of the same natural order (Solanacae), 
such as belladonna, dulcamara and stramonium. 

The treatment is the same as for aconite. 



(OF* Insure in The Mutual Life Insurance Co. of New York.) 



Lobelia. 



VEGETABLE POISONS. 105 

LOBELIA ("INDIAN TOBACCO"). 

This vegetable is not now much used as a medicine 
by physicians, as comparatively recent chemical dis- 
coveries have added substitutes to the list of drugs, 
which do not possess the peculiar disadvantages of 
this substance. 

In poisonous amount lobelia belongs to the class of 
acro-narcotics spoken of under the head of "Aconite" 
(p. ioo). Fortunately one of the symptoms follow- 
ing its use is vomiting. This should be encouraged 
by drinks of tepid water, gum-arabic water, etc. ; and, 
if kept up until all the poison is rejected by the stom- 
ach, a favorable issue may be expected. Should vom- 
iting not occur at once, as a symptom, enough of the 
poison may be absorbed into the blood to exert a fatal 
narcotic influence upon the brain and nervous system ; 
or, to speak more precisely, through these organs 
upon the movements of respiration and circulation. 



OPIUM. • 

This substance, or the numerous preparations of it 
used in medicine, is one of the most frequent causes 
of poisoning a physician is called to see. A com- 
mon mistake is that of confounding laudanum and 
paregoric ; a teaspoonful of the former contains six 
grains of opium, but of the latter only one-quarter of 
a grain. When the latter is supposed to have been 
given by the nurse, the mistake is not found out until poisoning 
it is often too late to be of material service in averting 
a fatal end. Morphine, the active principle of opium, 
is often kept as a solution, in private houses, for do- 
mestic use. 



Sources of 
opium 



C3T Insure in The Mutual Life Insurance Co. of New York.) 



106 



VEGETABLE POISONS. 



Treatment 
of opium 
poisoning. 



Any of these preparations of opium, in improper 
doses, are followed by symptoms of narcotic poison- 
ing. Not only these, but many popular nostrums, as 
"infant cordials" and soothing syrups of various kinds 
depend for their utility upon some preparation of 
opium, and are hence often followed by symptoms of 
narcotic poisoning. None of these things should be 
used. If a child cries, it does so usually because it 
feels pain ; and instead of making it stupid with nar- 
cotics so that it can not feel the pain, it is better to 
go to work to find out the cause and remove it. 
There is some reason for the suspicion that, in many 
instances, where a modicum of the popular remedies 
of this class are not furnished by the mother to the 
nursery, the enterprise of the nurse ("rather than see 
the child suffer"), secures it from a neighboring apoth- 
ecary shop for the charge committed to her care. 

Opium, its preparations, and the active principle of 
the drug, morphia, all act in the same way, by ab- 
sorption into the blood, and distribution by it to the 
brain and nervous system. Through these organs 
the movements of the chest and heart become more 
or less interfered with. In this respect, its action is 
essentially like that of carbonic acid gas, alcohol and 
most of the vegetable poisons herein described, with- 
out, however, any acrid or irritating complication. 

Treatment. — What is in the stomach must be taken 
out, to prevent further absorption, and what is in the 
blood must be worked out, under proper guidance, 
by the processes of nature constantly engaged with 
such products. If the breathing and circulation tend 
to cease, because of the inability of the brain and 
nervous system to temporarily discharge these duties, 



(jt^~Insure in The Mutual Life Insurance Co. op New York.)] 



VEGETABLE POISONS. 107 

these essential movements must be taken charge of 
by a friend. 

An active emetic, like ground mustard, must be 
given at once, remembering that trouble* may be 
found in getting it to act, because of the diminished 
sensibility to its presence, from the local stupefying 
action of the opium upon the mucous membrane of 
the stomach. The action of the mustard should be 
assisted by tickling the inside of the throat with the 
fingers or a feather. 

Sulphate of zinc, salt and water, pulverized ipe- 
cacuanha may be given ; in fact, anything to empty the 
stomach as soon as possible. 

If the respiration is not suspended, but is going on 
at a diminished rate, above eight to the minute, arti- 
ficial respiration is not required, until the number of 
respiratory movements of the chest falls below this. 
A strong stimulant, in the shape of twenty or thirty 
drops of aromatic spirits of ammonia in a tablespoon- 
ful of water, may be given three or four times, at inter- 
vals of a couple or more minutes. It is better than . reat ™ ent 
brandy, or anything alcoholic, because the mode of cases 
action of brandy is much the same upon the brain Q f opium- 
as opium, and it might be rather adding to than tak- poisoning, 
ing from the poison that is at work. A few table- 
spoonfuls of very strong, freshly made coffee is a use- 
ful thing to give in such cases. If potassium per- 
manganate can be obtained, it should be given in 
doses of five grains in water every fifteen minutes until 
four doses have been taken. 

The most efficient antidote is belladonna or its act- 
ive principle, atropine. Ten drops of the tincture of Antidote, 
belladonna or one-hundredth of a grain of atropine 
should be given every fifteen minutes until four doses 



(|^*Insure in The Mutual Life Ixscbaxce Co. op New Toek.) 



108 



VEGETABLE POISONS. 



Treatment 
in severe 

cases 
of opium- 
poisoning. 



After- 
treatment. 



have been taken. No more than this should be given 
without the advice of a physician. 

When the respirations get below eight to the min- 
ute, it is necessary to resort to artificial breathing by 
Sylvester's method (see p. 16). We may have to 
keep this up for hours before all danger is past. It is 
well to stop every fifteen minutes for a minute or two 
in order to see if the natural respirations will main- 
tain themselves at a rate over eight a minute. As 
long as this is the case we can rest ; but the breathing 
must be carefully noted all the time and counted with 
a watch. The body and extremities must be kept 
warmly covered and hot water bottles used, if neces- 
sary. The old measures of walking the patient around 
or of dashing him with cold water are only mentioned 
in order to be prohibited. They exhaust without do- 
ing any good. 

In case medical assistance shall not have been se- 
cured, and the patient shows signs of improvement, in 
the shape of more frequent respirations, stronger pulse 
and returning consciousness, many of these measures 
may be omitted as the apparent necessity disappears. 
In a short time the patient will appear as a person who 
is soundly sleeping from the effects of a full dose of 
opium or other narcotic, the quantity beyond that 
having been parted with by the blood. He may now 
be let alone, unless some return to the previous con- 
dition is noticed, when a dose or two of the strong 
and easily procured stimulant, aromatic spirits of am- 
monia, or coffee, may again be given him. If neces- 
sary, artificial respiration must be resumed. 



(|^*Insure in The Mutual Life Insurance Co. op New York.) 



Oxalic 
acid. 



VEGETABLE POISONS. 109 

OXALIC ACID. 

This substance is largely used in the arts, and in 
private households, for removing stains of iron from 
textures and surfaces, which it does by combining with 
an otherwise insoluble salt of iron, and converting it 
into a soluble oxalate of iron, easily removable by 
water. From the strong resemblance oxalic acid bears 
to Epsom salts, it has often been taken instead of the 
well-known purgative of that name. To avoid the 
possibility of such an accident, oxalic acid should be 
kept in another part of the house from which medi- 
cines are kept, and no precaution omitted, by label and 
other marking of the parcel, to make the difference 
between them as decided as possible. It is well to 
remember also that, wholly unlike Epsom salts, the 
taste of oxalic acid, applied to the tongue, is quite 
sour. 

When swallowed internally the activity of this poi- 
son admits of no delay. It belongs to the class of irri- 
tant poisons spoken of so often, and produces death 
chiefly by destructive action on the mucous membrane 
(lining) of the throat, stomach and bowels. 

Time can scarcely be lost to give an emetic; but 
something must be given to rapidly combine with the 
poison and divert its activity from the parts men- 
tioned. It has a strong affinity for lime, forming with 
it a comparatively insoluble oxalate of lime ; and for 
magnesia, forming with it an insoluble oxalate of mag- 
nesia, which can be dislodged with less haste. A tea- Antidote for 
spoonful of lime from a whitewash bucket or at the oxallc acid - 
bottom of the bottle of lime water, when made as di- 
rected in another place (page 162), mixed with a cup 
of water, might be given every few minutes, or some 

(t3F*Insure in The Mutual Life Insurance Co. op New Yoak.) 



110 



VEGETABLE POISONS. 



Oxalate of 
potash, or 
salts of 
lemon or 
sorrel. 



crushed chalk (a carbonate of lime), or some mag- 
nesia, may be given. All these things can easily be 
had, and not a moment need be lost in getting the per- 
son to swallow them. The common "whiting" used 
for polishing glass, making cheap paint and putty, is 
essentially the same as prepared chalk. After the 
oxalic acid is supposed to have been neutralized, an 
emetic of ground mustard or pulverized ipecacuanha 
may be given. 

Scraping the ceiling or wall will not procure the anti- 
dote if plaster of paris has been used instead of com- 
mon lime, as is often the case. The often recommend- 
ed mantel images of plaster of paris are also of little 
use. Lime in the sulphate (plaster of paris) is too 
firmly united to the sulphuric acid to give it up for 
oxalic. 

Oxalate of potash, commonly called salts of lemon 
or salts of sorrel, produces the same result as oxalic 
acid, and the treatment is the same. 



PULSATILLA. 



Pulsatilla. 



"meadow anemone," or 



The eating of this plant, 
parts of it, has been followed by symptoms of acro- 
narcotic poisoning. The plant is so active at times 
that when applied externally, irritation to the parts 
touched is felt. When poisoning results from swal- 
lowing it, the course of treatment recommended under 
"Aconite" (p. ioo) may be followed. 



SANGUINARIA ("BLOOD-ROOT"). 

Sanguinaria Taken internally in an overdose, acts as acro-narcotic 
poison. See "Aconite" (p. ioo). 

(i3T Insure in The Mutual Life Insurance Co. or New York.) 



VEGETABLE POISONS. Ill 

SAVIN E. 

This is an active irritating poison, inflaming the 
stomach and bowels. When thus taken, vomiting, by 
tickling the throat with the finger or a feather, should 
be at once induced. The mucous membrane (lining) 
of the bowels should be protected from the irritating Savlne - 
action of what has escaped be3/ond the stomach before 
it could be emptied by vomiting, by drinking large 
quantities of water or milk, with good quantities of 
gum-arabic dissolved in it. If the oil of savine, which 
is the usual form of the substance when used with a 
criminal intent, has been taken, it might be well to 
take a dose of castor oil. 

SPIGELIA. 

The use of this plant, commonly called "pink root," 
as a destroyer of worms, was given, it is said, to the 
whites by the Cherokee Indians, and has become very 
general throughout the entire country. It is given 
with a great deal of confidence and recklessness, and 
is often followed by symptoms of a narcotic charac- 
ter, attended also with convulsive movements. When 
such poisonous symptoms follow its use, vomiting plge ia " 
should be promoted and kept up by frequent draughts 
of warm water. As in the case of other narcotics, a 
drink of strong coffee may be of service. Acidulated 
drinks, as water and vinegar, water with lemon juice, 
are thought to be useful, and probably are, in favoring 
the elimination of the poison absorbed into the blood, 
by the action of the skin and kidneys. 



(Z%~ Insure in The Mctcal Life Insurance Co. of New York.) 



112 VEGETABLE POISONS. 

STRAMONIUM. 

Usually known as "thorn apple" or "jimson weed," 
belongs to the same natural order in botany as bella- 
donna, dulcamara and hyoscyamus; and when taken 
internally, in improper quantities, is followed by sim- 
ilar general symptoms. Children often gather the 
seeds and eat them. A history of the case, the evi- 
dence of some of the seeds or capsules, the narcotic 
Stramonium S y m ptoms, with the peculiar duskiness of the face and 
dryness of the mouth and throat mentioned when 
speaking of belladonna, are sufficient to point out the 
vegetable used. There is a decided disposition to 
laugh and to pick at imaginary objects on the part of 
the person under its effects. 

Treatment is the same as for aconite. 

STRYCHNIA. 

This is the active principle of the nux vomica, or 
"dog button,'' as it is sometimes called, from the use 
often made of it. This poison acts in a peculiar man- 
ner upon the nervous ystem, throwing the muscles of 
the body into strong convulsive movements. There 
is a disposition during, the convulsion, for the heels 
and the back of the head to meet (opisthotonos), 
under the influence of the violent muscular move- 
ments. Whenever this is seen, and if seen it will 
surely be remembered, the coincidence between it and 
the use of strychnia should be remembered. 

The stomach should be evacuated with the least pos- 
sible delay, if it is known the person has just taken 
the poison. The patient must be kept quiet in bed in 
a room which is darkened and has the windows and 



Strychnia. 



(JSP* Insure in The Mutual Life Insurance Co. of New York.) 



VEGETABLE POISONS. 113 

doors shut. Thirty grains of bromide of sodium or 
potassium should be given at once and may be re- 
peated in fifteen minutes. Ten grains of chloral hy- Treatment, 
drate can be added to each dose with marked benefit. 
It may be necessary to repeat these medicines a third 
or even a fourth time, but care should be taken not 
to overdose. 

TOBACCO. 

To a person not accustomed to its effects, tobacco 
is an acro-narcotic poison, agreeing in its essen- 
tial character with aconite, and others of the same Tobacco, 
general class. The movements of the heart become 
so much interfered with that death may take place 
unless proper assistance is at once given. Fortu- 
nately, like lobelia, it acts as an emetic, and before 
enough can be absorbed into the blood from the stom- 
ach, the contents of that organ are rejected. Hence, 
when death has ensued from the direct use of tobacco 
we find that it was used as an injection, a form in 
which it should never be given. 

OTHER VEGETABLE POISONS. 

Besides those enumerated in the foregoing pages 
are many others, whose names even cannot be here 
given. Most of them belong to the acro-narcotic 
class and may be treated as advised in speaking of 
those mentioned under that head. See "Aconite" 
(page ioo). 



(J^"Insure in The Mutual Life Insurance Co. of New York.) 



SECTION IV. 



CARE OF INVALIDS. 



To those who are lying upon beds of anguish and 
possibly mortal illness, there can be nothing more 
comforting 1 than the thought that a policy of insur- 
ance in The Mutual Life Insurance Company 
of New York protects those who are dependent 
on them. 



VENTILATION. 117 



VENTILATION. 

JVIost readers know that the bodies of animals are „,, . , am 

r The blood is 

constantly undergoing changes ; the old particles, purified by 

becoming worn out and useless, are thrown into fresh air. 

the blood and carried away, while new ones are taken 

from the blood and put in their places. These decaying 

particles, as soon as they become useless, must be 

carried away through the blood and out of the body. 

The chief means by which this end is accomplished 

is through the use of pure air, which washes away 

these impure particles from the blood. This air enters 

pure, through the mouth and nostrils into the lungs, 

and comes out laden with these poisonous materials. 

If these decaying particles are taken into the lungs 

again, they not only prevent the escape of the poisonous 

materials from the body, but really add more poison to 

it. Soiled air can no more purify soiled blood than 

soiled water can cleanse soiled clothes. There is one 

thing that can do it, and that is, plenty of pure air. 

Now, the question is, how much pure air does it 
require to answer this purpose? You may have some . 
idea of it when you remember that an ordinary man a j r nee ded 
spoils not less than 3,000 cubic feet of pure air. every for purifying 
hour. A sick person needs much more. He should the blood, 
never be put in a room that contains less than 1,500 
cubic feet of air space, i. e., it must be at least 15 feet 
long, 12 feet wide, and 9 feet high, allowing a little 
for furniture. Even then the ventilation needs to be 
very good. 

Not only is the air of a room made impure by breath- 
ing, but it is made impure by the gas we burn as a 

(S£T~ Insure in The Mutual Life Insurance Co. of New York. ) 



Do not close 
a fire-place. 



118 VENTILATION. 

Effect of gas n S nt - It is estimated that an ordinary burner con- 
and stove on sumes as much air as eleven men would do — that is, 
the air. one gas burner in three-quarters of an hour con- 

sumes as much air as would answer a man for a whole 
night. If there is an ordinary stove in the room it de- 
stroys as much air as would twenty-five men. All these 
facts and estimates must be thought of when you hesi- 
tate sometimes about putting up or letting down a 
window a few inches. 

If the house is an old one there may be a fireplace 
in the room. If so, do not attempt to seal it up "be- 
cause the air comes in" — as air is just the thing you 
want — but leave it open, or at least the best part of it. 
If the house is a more modern one, there, is perhaps, a 
"flue" ; if so, do not upon any excuse attempt to close 
it, but let it alone. 

A great many persons have an idea that this letting- 
in of pure air, or "ventilation," means raising a window 
a little from the bottom, or opening a door a short 
distance. They never mind much where the window 
must enter or door opens into — it is all the same, so they open 
and foul air somewhere. The idea is not correct. Ventilation 
escape. no t only means providing a way for the pure air 

to come in, but for the bad air to get out. This can 
usually be accomplished by drawing down the top sash 
a few inches, which will let the heated impure air out 
of the room, and by raising the lower sash a few 
inches to let the fresh air into it. If you wish to 
know that the hot air really goes out at the upper 
opening, hold a lighted candle near it, when the 
blaze will be carried outward by the force of the 
escaping current ; and if you will hold it to the opening 
below, the flame will point inward from the current 
of cool air which comes from without. A more certain 



Fresh air 



(OT" Insure in The Mutual Life Insurance Co. op New Yobk.) 



VENTILATION. 



119 



way to secure the proper amount of fresh air is to 
have openings on opposite sides of the room, so that 
the air will circulate through the chamber as much 
as possible. 

Remember not to have the current play over the 
bed on which the person lies sleeping, as the person 
miedit catch a cold. But if there is no other way — . .. . , 

" J Avoid a draft 

and some rooms are so constructed that no other if possible. 
means appear possible — it is better to open the win- 
dows, and escape the effects of the draught, by putting 
an extra covering over the person. Should there be 
only one window in the chamber, raise that and open 
the door a little. If you can contrive no means by 
which a desirable amount of pure air can be per- 
manently secured, bear the matter in mind, and some 
day when your physician comes in ask him about 
it. Persons who habitually sleep in badly ven- 
tilated houses are seldom compelled to wait long for 
such an opportunity, as he is frequently summoned to 
the occupants of these houses. 

If pure air is so important to people who call 
themselves in health, how much more important is 

it to those who are sick. The lungs try to throw the l ^f° n ^ 
1 1 re 11 iiii i , °f fresh air 

load off, as can be detected by the heavy odor of to the s j ck# 

the breath ; the skin is trying to do the same thing, as 

you will perceive by its sickly, clammy feeling; and 

a physician will see that a dozen different attempts 

are made in one place or another, with the same 

object in view. These noxious materials, as they 

are cast off, tend to poison the surrounding air; 

so we must assist nature in relieving the patient by 

keeping a constant supply of fresh air in the chamber 

where he lies. Not only do we assist in curing the 

patient, by carrying away these poisonous materials 

(E^" Insure in Thk Mutual Life Insurance Co. of New York..) 



120 



VENTILATION. 



Prevalence 



winter. 



by plenty of pure air, but, at the same time, we greatly 
lessen the chances of other persons contracting disease 
by breathing the contaminated atmosphere. 

Most observers have noticed that certain contagious 
diseases, as small-pox, scarlet-fever, etc., are very apt 
to prevail during the winter. The reason is a simple 
ofcontagious one — because the poisonous or contagious principle is 
diseases in kept confined in the room through fear of admitting 
the cold. It becomes so concentrated and virulent 
that it is capable of producing the disease in others. 
In warmer weather, this prejudice against fresh air 
does not exist ; the doors and windows are kept open, 
the fresh air enters in abundance and dilutes the 
emanations so much that they lose their power to 
extend the disease. These diseases then diminish until 
closed doors come again with the cold weather. This 
is not only the case in low fevers, scarlet fever, etc., 
but the same principle holds true with most other 
diseases, so that the first and la§t thing a nurse should 
do is this : 

Keep the air the sick person breathes as pure as the air 
outside without chilling him. 

Many persons think, as before remarked, that the 
right thing has been done if a door or window is 
opened, never minding where the air comes from, 
whether from a close entry, a foul kitchen or even 
from an untidy water-closet. If the air does come 
already foul. fr om an y suc h pi ace> the sick-room is not aired, 

but only more poisoned. The kind of air one requires is 
the best air of the neighborhood, and this usually 
comes from the outside of the house. 

With plenty of open windows to let in the pure air, 
and a little burning fuel to take off the chill, it is an 
easy matter to get that kind of air which all sick 



New air 
must not be 



(IGP-Iiisure iu The Mutual Life Insurance Co. op New York.) 



TEMPERATURE. 121 

persons need. It is a rare thing for a person to 
"catch cold" while in bed. Indeed, some physicians «c^ ^jj 
say they never saw a case of it from such a cause, and co id" i n bed. 
if the bed-clothes are properly tucked in about the 
shoulders it is hard to imagine how such a thing could 
occur, unless the air is so cold that it acts upon the 
lungs as it would upon the ear, nose or fingers, directly 
inflaming the organs of respiration as if by "frost bite." 



cold. 



TEMPERATURE. 

Cold has been called "the great enemy of age," and 
as the same inability to resist death is found in the Influence of 
sick as in the aged, cold may be said to be the great* 
enemy of the weak. The report of the Registrar-Gen- 
eral of Great Britain for the cold months of the year 
1875 shows that, while there was no new malady, but 
only the familiar forms of bronchitis, phthisis pulmo- 
nalis (consumption) and pneumonia (inflammation of 
the lungs) — always holding their own in the returns 
of the causes of death — yet these well-known diseases 
were answerable for a number of victims greatly 
in excess of the average. Thus, where the weekly 
average for ten years from the three specified causes 
had remained about stationary during the prevalence 
of the cold weather of December, there was an increase 
of twenty-five per cent, in the death rate. The prob- 
able or, at least, the only assignable cause of this 
mortality, was the low temperature which prevailed. 
This is true as to the cause of death ; and the same 
authority shows that the death rate from all causes, 
among persons 60 years old and upward — which 

(I^*InsTire in The Mutual Life Insurance Co. of Xew York.) 



122 



TEMPERATURE. 



Influence of 
heat. 



One avoid- 
able way 
of catching 
cold. 



previously stood at 62 per thousand of all the deaths 
from these causes — rose during seven cold weeks to 
130 per thousand, and during the cold weather of the 
last two weeks of December, 1874, rose still higher, to 
150 per thousand. 

While cold leads to a great mortality among the 
weak and aged and the very young it cannot be 
doubted, on the other hand, that in warmer latitudes 
reliable statistics would prove that the heat of 
summer leads to quite as great a mortality among the 
aged and debilitated. Ordinary observation will sat- 
isfy any one of the truth of this about young children. 
Now, for practical purposes, there is a little differ- 
ence between an aged or a young person and a sick 
one. Hence, because violent and extreme changes 
should be avoided, as much as possible, at the periods 
of life mentioned — cold proving most destructive to 
the aged, and heat to the young — a corresponding 
carefulness should be observed in regard to the sick 
of every age. 

The consideration of these facts naturally leads to 
the inquiry whether we are helpless under the con- 
ditions which they disclose ; but common sense and 
experience fortunately show that we are not. While 
the susceptibility is doubtless increased by the sudden 
variations of temperature referred to, the question 
appears whether the still greater variations to which 
people unthinkingly expose themselves may not be 
quite as dangerous. In this respect, an audience just 
leaving a hall or place of amusement is an instructive 
sight. It includes numbers of delicate women who 
habitually dress in furs and warm wraps, who 
have been sitting for two or three hours, with 
low dresses, in a heated, vitiated and relaxing 



(KP*Insure in The Mutual Life Insurance Co. op New Yoek.) 



TEMPERATURE. 123 

atmosphere. These wait, before starting home, in 
a cold, draughty lobby, standing in thin shoes, 
and while talking and laughing with their friends, 
take deep breaths of the raw cold air into lungs 
which have been previously breathing a vapor- 
bath. Many of these changes of temperature inci- 
dent to the customs of society are of a purely artificial 
character, scarcely to be resisted by the strong with the 
best of health. The waste of health and strength is 
often too great for the robust, and the weak had better 
avoid them. 

Many of the illnesses deplored under this head are 
doubtless due to the direct shock given by the sudden 
entrance of a volume of cold air into the lungs, which 
could have been avoided almost entirely by the simple t h rou „ h the 
expedient of breathing only through the nostrils, and n ose. 
keeping the lips closed, so that the air would have 
become warmed before entrance into the lungs. 

The sudden changes from heat to cold do not all 
take place away from home. Many "colds" are 
due to the arrangement of private houses, which 
appear to be built for neither heat nor cold, and do Risks within 
not resist either. A person going from the house the house - 
to the outside cold air has been taught to put on a 
coat ; but a person going from one room to another has 
not this fear, and steps into a cold bath without 
warning. We say cold bath, for practically the com- 
municating entries of the house, with gas-burners at 
every landing of the stairs, are as well devised a 
means of getting the heat from the lower rooms, 
where needed, to the garret, where not needed, as 
if specially designed for the purpose — particularly 
if the lower outside doors are occasionally opened. 
Invalids should therefore always pass through entries 

(JJTlnsure in The Mutual Life Insurance Co. of New York.) 



Invalids 



124 TEMPERATURE. 

and long stairways as well protected as if going into 
cold air on the other side of the front door. 

A time when people are very apt to catch cold is 
just after getting up from a warm bed, when the skin 
has become somewhat relaxed from many hours, or 
perhaps days, of lying there, and is rendered less 
capable of reaction. The same temperature which re- 
must not be freshes a patient in bed while protected by the bed- 
chilled, clothing, might destroy the patient just arisen. Com- 
mon sense will tell us that while we want pure air, we 
of course want that which cannot chill the sick person. 
After all, a cold is as often the result of de- 
bility as the direct exposure to a draught of cold 
air. If each individual will observe his own case the 
next time a cold is contracted, he will find, more than 
A cold is likely, that it was preceded some days by lassitude, 
frequently headache, more or less inability to exercise the think- 
ing faculties with the usual success, disturbed diges- 
tion, etc., etc. These symptoms have all become ex- 
aggerated by a very slight exposure, and sometimes 
the cold appears without any remembered exposure. 
When the above-named symptoms appear, it is wiser 
to examine into their cause rather than to inquire 
what particular exposure to a draught of air gave rise 
to the cold. A discovery of the remote cause of the 
attack may place it in the power of the person to pre- 
vent a recurrence, and a judicious, generous diet and 
attention to fresh air will often give more relief than 
"Squills" and other domestic remedies of the same 
kind. 

In many diseased conditions much less heat is pro- 
duced than in health ; and there is a constant ten- 
dency to a decline and ultimate extinction of the vital 
powers by the call made upon them to sustain the heat 

(J3jT Insure in The Mutoal Lifb Insdrancb Co. op New York ) 



debility. 



TEMPERATURE. 125 

of the body. In such cases, the patient should be 

carefully observed every little while, and as soon as i nva lids 

this tendency is discovered, the temperature of the produce less 

body should be kept up by heat externally applied, as heat than the 

warm bricks, tin cans or bottles filled with hot water, we e ^ pe " 

etc. Such cases of decline of the heat of the body occur m . 

~ _ morning. 

at all times, even in summer. This coldness, indicat- 
ing a decline of vitality, is most apt to happen to- 
ward morning, at the time the effect of the preceding 
day's diet begins to be exhausted. Everybody knows 
that it is usually toward the morning that we begin 
to suffer from the effects of cold, because the vital 
forces are then beginning to slacken from the want 
of food. If this is the case in health, it is the same 
in disease. Hence, from midnight until nine or ten 
o'clock the next morning, the condition of the patient 
should always be carefully watched, and as soon as 
want of heat is noticed the nurse should at once take 
means to counteract it. 

During the day time the temperature of the room 
should be kept about 70 degrees. The night tempera- 
ture should vary according to the health of the occu- ture of 
pant. If that is good, it can be as low as 50 degrees, room, 
or even 40 degrees, without discomfort, provided the 
bed-covering is sufficient. If the occupant is an in- 
valid, the temperature should not fall much below 60 
degrees. It will often be necessary to stir up a little 
heat in the early morning to prevent too great a fall. 



(tW Insure in The Mutual Life Insurance Co. op New York.) 



126 CHAMBER UTENSILS. 

CHAMBER UTENSILS. 

Nothing should ever go into the "slop-pail" of a 
chamber but the refuse water from the wash-basin, etc., 
and then it should stand no longer than necessary. 
Under no circumstances whatever should the contents 
of any utensil used about the bed ever go into it.* 

* Some observations by Florence Nightingale upon these 
matters are given here from "Notes on Nursing" : 

"The use of any chamber utensil without a lid should be 
utterly abolished, whether among sick or well. You can easily 
convince yourself of the necessity of this absolute rule by 
taking one with a lid, and examining the under side of that lid. 
It will be found always covered, whenever the utensil is not 
empty, by condensed, offensive moisture. Where does that 
go when there is no lid ? 

"But never, never should the possession of this indispensable 
lid confirm you in the abominable practice of letting the 
chamber utensil remain in a patient's room unemptied except 
once in twenty-four hours — i.e., when the bed is made. Yes, 
impossible as it may appear, I have known the best and 
most attentive nurses guilty of this ; aye, and have known, too, 
a patient afflicted with severe diarrhoea for ten days, and the 
nurse (a very good one) not know of it because the chamber 
utensil (one with a lid) was emptied only once in twenty-four 
hours, and then by the housemaid who came in and made the 
patient's bed every evening. As well might you have a 
sewer under the room, or think that in a water-closet the plug 
need be pulled up but once a day. Also take care that your 
lid, as well as your utensil, be always thoroughly rinsed. 

"If a nurse declines to do this kind of thing for her patient, 
'because it is not her business/ I should say that nursing was 
not her calling. I have seen surgical 'sisters,' women whose 
hands were worth to them two or three guineas a week, down 
upon their knees scouring a room or hut, because they thought 
it otherwise not fit for their patient to go into. I am far from 
wishing nurses to scour. It is a waste of power. But I do say 
that these women had the true nurse-calling — the good of their 
sick first, and second only the consideration what it was their 
place to do — and that the women who wait for the housemaid 
to do this, or for the charwoman to do that, when their patients 
are suffering, have not the making of a nurse in them. 

"Earthenware, or, if there is any wood, highly polished and 
varnished wood, are the only materials fit for patients' utensils. 
The very lid of the old abominable close # stool is enough to 
breed a pestilence. It becomes saturated with offensive matter, 
which scouring is only wanted to bring out. I prefer an 

$W Insure in The Mutual Life Insurance. Co, op Nkw Yokk.) 



DISINFECTANTS. 



127 



DISINFECTANTS. 



An able medical lecturer in Philadelphia is in the 
habit of tersely saying before his class that fumiga- 
tions, as a rule, act on the principle of "one stink stink- 
ing out another stink." There is a deal of truth about 
it. The popular idea is that they destroy filthiness. 
Used in the ordinary way, they can do no such thing. 
They only make filthiness less evident, because they 
make the odor less perceptible, which is an indication 
of its presence. Remove the cause, and all the un- 
pleasant effects must cease. 

At the present time it is known that many diseases 
are caused by small living organisms, called microbes. 
Among these diseases are consumption, cholera, yel- 
low fever, typhoid fever, typhus fever, diphtheria, 
whooping-cough, small-pox, measles, scarlet fever and 
several others of less importance. Each of these is 
caused by its own particular microbe, which can be 
transferred to a healthy person and then start up the 
original disease. These microbes may be present in 
the dejections, in the vomit, in the expectoration, in 
the breath, or may be detached from the skin. In 

earthenware lid as being always cleaner. But there are various 
good new-fashioned arrangements. 

"A slop-pail should never be brought into a sick-room. It 
should be a rule invariable, rather more important in the 
private house than elsewhere, that the utensil should be carried 
directly to the water-closet, emptied there, rinsed there, and 
brought back. There should always be water and a cock in 
every water-closet for rinsing. But even if there is not, you 
must carry water there to rinse with. I have actually seen in 
a private sick-room the utensils emptied into the foot-pan. and 
put back unrinsed, under the bed. I can hardly say which is 
most abominable, whether to do this or to rinse the utensil in 
the sick-room. In the best hospitals it is now a rule that no 
slop-pail shall ever be brought into the wards, but that utensils 
shall be carried direct, to be emptied and rinsed at the proper 
place. I would it were so in the private house." 

(EP* Insure in The Motcax Life Insurance Co. op Kbw York.) 



Fumigation 
is usually 
worthless. 



Diseases 
which are 
due to 
microbes. 



128 DISINFECTANTS. 

order to destroy them it is necessary to use disin- 
fectants which will kill them. In order to be of any 
avail, a disinfectant should remain in contact with the 
substance to be disinfected a sufficient length of time 
to accomplish the object in view, otherwise it is value- 
less. 

Among the disinfectants the following are the most 
important. For convenience they will be called 

STANDARD DISINFECTANT SOLUTIONS. 

No. I. Chloride of Lime. — This has an odor 

which is quite offensive to many. It bleaches clothing 

readily and may even destroy delicate fabrics. A 

di i fe t standard solution of 4 per cent, strength is made by 

solutions adding six ounces to a gallon of pure water. 

No. 2. Bichloride of Mercury. — Commonly 
known as "corrosive sublimate." This cannot be used 
in contact with metal, as it is precipitated. A standard 
solution is made in the strength of 1 to 500 by adding 
fifteen grains to a pint of water. 

No. 3. Carbolic Acid. — A standard solution of 
5 per cent, strength is made by adding seven ounces 
to the gallon of water. 

No. 4. Solution of Chlorinated Soda. — Com- 
monly called Labarraque's Solution. It bleaches veg- 
etable colors slowly. A standard solution of this in 
10 per cent, strength is made by mixing it with nine 
parts of water. 

No. 5. Chloride of Zinc. — A standard solution of 
this in 10 per cent, strength is made by adding a pound 
to the gallon of water. 

All of these solutions are very poisonous and must 
be handled with care. To leave a dish of carbolic acid 

(tW Insure in The Mutual Life Insurance Co. of New York.) 



DISINFECTANTS. 129 

in the room or to sprinkle some chloride of lime on 
the floor does not hurt the microbe unless the microbe rjisinfect- 
happens to fall into it. Disinfectants must be applied ants must be 
directly and thoroughly to the microbe-carrying sub- applied 
stance in order to do their work properly. The fol- thoroughly, 
lowing rules are given for the purposes noted. 

FOR EXCRETA. 

Mix each stool thoroughly with two quarts of 
No. i, the standard solution of chloride of lime, or 
of No. 3, the standard solution of carbolic acid. Let it Disinfection 
stand at least one hour with the former and four hours of excreta, 
with the latter before emptying. For privy-vaults 
and cesspools, use liberal amounts of No. 2, the 
standard solution of mercury bichloride , or of No. 3, 
the standard solution of carbolic acid, and scatter 
plentifully over the surface chloride of lime in powder. 
Rub down the walls frequently with No. 3, the stand- 
ard solution of carbolic acid. These measures are of 
especial value in cholera, typhoid, dysentery and 
tuberculosis. In cholera, diphtheria, yellow fever and 
scarlet fever, all vomited material should be treated 
in the same way. 

FOR THE EXPECTORATION. 

This should be discharged into a cup containing 
a considerable quantity of No. 1, the standard solu- Disinfection 
tion of chloride of lime, or of No. 2, the standard of expecto- 
solution of mercury bichloride, to each pint of which ratlon » espe- 
fifteen grains of potassium permanganate has been cia . y . 
added. It should remain in this for several hours be- consum 
fore emptying. All cloths which have been used to tion. 
wipe the mouth should be burnt. These measures 

(SW Insure In The Mutual Life Insurance Co. op New York.) 



180 



DISINFECTANTS. 



are of great importance in consumption, diphtheria, 
scarlet fever and infectious pneumonia. When it is 
remembered that one-seventh of all deaths occur from 
consumption in some of its forms, and that it is very 
frequently caught by inhaling dried sputum, the im- 
portance of thorough disinfection in this disease can- 
not be too highly insisted on. 

FOR CLOTHING AND BEDDING. 



Disinfection 
of clothing 
and bedding. 



If of little value, destroy by fire. If it can be washed, 
boil for at least half an hour, or immerse for at least 
four hours in No. 2, the standard solution of mercury 
bichloride diluted twice, or in No. 3, the standard solu- 
tion of carbolic acid diluted once. If it cannot be 
washed, expose it for two hours to a dry heat at a 
temperature of 230 degrees Fahr., at least. Mattresses 
should have the cover removed or freely opened before 
disinfection. In fact, it is better to destroy them and 
blankets by fire. 



FOR THE PERSON. 



Disinfection 
of the 
person. 



The hands and bodies of the attendants and of con- 
valescents should be washed with No. 4, the 10 per 
cent, standard solution of chlorinated soda, or No. 3, 
the standard solution of carbolic acid diluted one-and- 
a-half times. 



FOR THE DEAD. 



Disinfection 
of the dead. 



Envelop the body in a sheet thoroughly saturated 
with No. I, the standard solution of chloride of lime, 
or No. 2,the standard solution of mercury bichloride, 
or No. 3, the standard solution of cabolic acid. 

(JBTlnsure In Tas Mutual Life Insubance Co. of New ?obk.) 



DISINFECTANTS. 131 

FOR THE SICK ROOM. 

While occupied, wash all surfaces occasionally with 
No. 2, the standard solution of mercury bichloride, 
diluted once, or No. 3, the standard solution of car- 
bolic acid, diluted once. 

After the patient has been removed, wash all the 
walls, floor and ceiling, and all other surfaces in the ls * n ectlon 

m 1 . . . , , ~r of sick-room, 

room. Then close it tightly by stuffing rags or papers 

in the cracks of the windows and doors. Burn in it 

at least three pounds of sulphur to every 1,000 cubic 

feet. A good way to do this is to take a washtub and 

put in it a few inches of water and several bricks. 

On the bricks place an iron pot containing the sulphur. 

Pour over this a pint of alcohol and set fire to it. 

Let the room remain closed for at least twenty-four 

hours. Then wash all the surfaces with No. 2, the 

standard solution of mercury bichloride, diluted once, 

or of No. 3, the standard solution of carbolic acid, 

diluted once, and then with soap and water. After this 

use quantities of fresh air and as much sunlight as 

possible. 

Do not think that this question of disinfection is of 

little moment. If vou remember that "an ounce ,, , 

Value of 

of prevention is worth a pound of cure," you will un- disinfect- 
derstand that a few cents spent for disinfectants may ants, 
save you a doctor's bill and possibly a funeral. And 
if you use them at all, do it thoroughly. Unless dis- 
infection is well done it is worse than useless, for it 
will induce a false sense of security. If you fail, do 
not blame these principles, but your own lack of at- 
tention to detail in carrying them out. 



(|^*Insure in The Mutual Life Insurance Co. of New York.) 



132 



CLEANLINESS. 



CLEANLINESS. 



Lack of 
cleanliness 
in the house. 



Untidiness a 
drawback to 
the sick. 



A house may be filthy even where there is not a 
pile of dirt anywhere to be seen. Carpets filled with 
dust and saturated with grease, uncleansed furniture, 
old papered walls of years' standing, are just as much 
sources of impurity to the air as a refuse heap in the 
cellar. They defile the atmosphere quite as much, 
and more or less tend to encourage disease. Sweep- 
ing with a broom certainly can remove much dirt from 
a floor, but what it does not sweep out it scatters 
through the air, making little true improvement. After 
the dust "settles/' the room is usually "dusted," which 
practically means whipping the dust from one piece 
of furniture to another with a bunch of feathers. 
It really seems that the dust had better be left alone, 
unless it can be removed altogether, and the only way 
to do this is to wipe everything with a damp cloth. 
The floor of a sick room should really be without a 
carpet, or if there is one, it should be well beaten 
before the patient goes into the room, and again well 
beaten and aired as soon as the person is done with it. 

Few people — no matter who they may be — have any 
idea of the exquisite cleanliness required in the sick- 
room. The smoky chimney, the dusty furniture, the 
utensils emptied but once a day, even in the best 
houses, keep the air of the sick-room constantly dirty. 
What a person in health "may put up with" for a 
night only, may prove a source of suffering, postpone- 
ment of recovery, or even the hastening of a fatal 
end, to the sick person who is confined there, perhaps 
in one posture for twenty-four hours. 

None but those who have been sick, and know from 
personal experience, can tell how much delicious com- 



($^~Insure iu Thk Mutual I.tfb Insurance Co. op Nkw York,) 



CLEANLINESS. 183 

fort may be secured by the careful washing and proper 
drying of the skin. It is not the mere feeling of com- r 
fort which has been obtained, but an absolute relief of the sick 
the vital powers by the removal of something which from bath- 
was oppressing them. Cleanliness of skin and ventila- ing. 
tion have much the same end in view — the removal of 
noxious materials from the system as rapidly as 
possible. 

The various methods of washing the sick cannot be 
given here for want of space ; besides this, the physi- 
cian is always ready to give any advice which may be 
needed. Care should be taken, in all these operations Do not chi11 
of sponging, washing and cleansing the skin, not to s 
expose too great a surface of the body at once, as this 
might check the perspiration and retard the re- 
covery from disease or renew the trouble in some 
other form. 

In several varieties of diarrhoea, dysentery, etc., 
when the skin is hard and harsh, the relief to the 
sick person from washing with water and an 
abundance of soap is almost beyond calculation. 
In other cases, sponging with tepid water and soap 
will be ordered, then with tepid water alone, followed 
by proper drying of the skin with a soft warm towel. anous 

« . 1 1 . , , « ■ , ways of 

bometimes when water alone is to be used, a little batn i n g 
vinegar added to it makes the sponging more refresh- an invalid, 
ing. Of course, no one would think of using vinegar 
at the same time that soap is used. Bay rum or 
cologne is very acceptable, also, to the face, neck and 
hands of sick people, when used after sponging or 
bathing. If not convenient to use this, some common 
spirits diluted with water may be substituted. 

In this connection, it may be well to remark that 
special care should be observed in the use of water for 



(CJTInsure ja Tub Mutual Life Insurance Co. op New Yo<;k.) 



Do not have 



134 CLEANLINESS. 

bathing persons suffering with debility, the result of 
sickness or of age. In such persons, it is often seen 
that a bath which could be used with benefit in robust 
health, or at a younger age, is followed by palpitation 
of the heart, slackened pulse, more or less vertigo, 
shivering, and other feelings of discomfort, which 
last some time after its use. In ordinary cases, 
the water ^ mav ^ e accepted as a good rule that when- 
too cold. ever a bath, hot, tepid, or cold, is followed by 

a sense of oppression or inconvenience of any kind, 
it has not done good, and it may be well to suspect it 
having done harm. The amount of heat required to 
vaporize moisture is much larger than is popularly 
supposed, and if the person, aged or sick, or both, has 
not that surplus of heat to spare for the special pur- 
pose, over and beyond what he is likely to need for 
the ordinary purposes of the body, more or less disas- 
trous results are invited from the reckless expenditure. 
Even healthy persons, accustomed to a morning bath 
of cold water, sometimes feel an instinctive repug- 
nace to it, and on such occasions this should not be 
disregarded, but some other form of bathing used. A 
sponge bath or a warm bath in a well-heated room will 
answer better, followed by drying with a warm soft 
towel. 

By age, the writer does not mean the number of 
technical years the person has lived, but refers rather 
to the effect which the work he has done has had 
upon the "constitution," as it is called. 

LIGHT, 

A dark house, wherever found, is always an un- 
healthy one as well. Want of light discourages 

(J3T Insure 5a The Mutual Life Insurance Co. of New York. 



LIGHT. 135 

growth, promotes scrofula, encourages "consump- 
tion," and, in fact, everything else which is bad. It T _.,.„_ 

J ° Importance 

is the unqualified experience of all who have had op- f light, 
portunities of judging, that light is second only in im- 
portance to fresh air; and the next worse thing after 
a close room is a dark one. Many suppose that it 
is upon the spirits only that sunlight acts, and not 
upon the body. The reverse is the case. It does the 
body good, and the brighter spirits show it. 

If possible, the sick-chamber should be the sunniest 
room of the house, and if the bed can be so placed that 
the person lying on it can see a good piece of the blue 
sky, so much the better will it be. If the patient can 
see out of two windows instead of one, he will be twice 
as well off. It is found in all hospitals that rooms 
facing the sun have fewer deaths, all other things con- Great value 
sidered, than such as are upon the shady side of the ° f sunshine 
house ; and where statistics have been kept for a period 
of years, it is found that the average time for recovery 
is less upon the sunny side than upon the shady side 
of the building. Not only do fewer patients die, per- 
haps, in the southerly exposed sides of hospitals, and 
sick people get well there faster than those on the 
northern exposure, but it has been shown recently that 
in asylums, prisons, etc., more of the inmates become 
ill who are compelled to dwell on the shady side of 
the building than of those who live on the sunny side. 

The first time the reader of this passes through the 
ward of a hospital, let him observe how almost all the 
patients lie with their faces turned toward the light. 
Ask one of them why he does so, and he will scarcely 
be able to give you an answer ; but you see he does 
it. The reason is deeper down than his understanding. 
It is his nature to do so, just as it is the nature of 

{$~3* Insure in The Mutual Life Insurance Co. or Net York.) 



136 



REST. 



Effect of 
noise on an 
invalid. 



Do not 
waken a 
sleeping 
patient. 



plants to always make their way toward the light, and 
their leaves or flowers to incline toward the sun. 
While you are looking at the faces turned toward the 
sunlight, count how many sick you see lying with 
their faces toward the wall. Among a hundred patients 
not more than half a score will be seen avoiding the 
light. 

REST. 

The loudness of a noise often does not hurt a 
patient. The putting up of a scaffold nearby, 
perhaps, will not trouble him — he knows what 
that is; while whispering or talking may annoy him 
beyond endurance. To some, however, any kind of 
noise is disturbing. A sharp and sudden noise, which 
is not steady, usually gives more distress than other 
kinds. Anything which suddenly awakens a patient 
out of his sleep will throw him into greater excitement, 
and consequently do him more harm than any con- 
tinuous sound, however loud it may be. 

When a patient sleeps never under any circum- 
stances let him be awakened, unless you have the sanc- 
tion of the physician. A sick person who has been 
asleep but a little while, and is then awakened, can 
very seldom go to sleep again ; while, had he slept 
a few hours, and then been aroused, he might have 
fallen asleep again in a few minutes with little effort. 
The reason is something like this : In a sick person 
the brain, as a usual thing, is weakened and debilitated 
like the other parts of the body and needs strength- 
ening. It gets this by sleep, which is rest. If rest is 
interrupted a few minutes after it begins, the brain is 
weakened so much more, and tends the less to sleep. 
The brain, therefore, not only loses the good of the 

(63?*Insure in The Mutual Life Insubance Co, op New Yobx.)] 



REST— NURSES. 137 

little sleep it has had, but also its ability to sleep, be- 
coming what physicians call "irritable." If a patient 
sleeps for a time, the brain becomes so much the 
stronger, and can the more readily rest the next time. 

No noise which excites a patient's expectation 
should be made in his room. Hence, no one should Do not 
ever speak in low tones near the bed of the patient, whisper 
or hold a conversation in a room or passage where before a 
the sick person can occasionally overhear a word. P atient - 
This is absolutely cruel. 

Another thing is frequently done by a thoughtless 
nurse. When she wishes to make some special in- 
quiry of the physician in regard to the condition of 
the patient, she usually remains in the room until the 
physician is ready to leave it and then states, with an 
air of conscious importance, that she has "something 
particular" to ask him about the patient. 

NURSES. 



Amateur 



The tact and qualities needed in the sick-room are 
not alwavs the result of experience, nor do amateur 

r ' nursing 

nurses always possess them. Now and then a lady is usually , 
born to them, and the physician to that house re- failure, 
joices exceedingly; for his own credit, as well as the 
recovery of the patient, is probably assured. He sel- 
dom, however, has this good fortune, because geniuses 
are not common. Many nurses cannot observe, and 
they will not think. The fire is alternately half ex- 
tinct, and blazing up the chimney. It is not warm at 
sunrise and sunset, and moderate at midday, when 
the sun shines warmly. No care is taken to continue 
a priceless sleep, by keeping the cinders from falling 
on the unprotected fender ; or to gently restore the 

|t^ Insure In The Mutual Lips Insukance Co. op New Yoek.) 



188 



NURSES. 



Affection not 
a substitute 
for experi- 
ence. 



Tact of a 

trained 

nurse. 



fire by quietly putting on lumps of coal, previously 
wrapped in pieces of damp paper, ready for noiseless 
use. The desired morning meal is brought in after 
the patient has passed from appetite to faintness. 
More than likely the tea is smoked. It is painful to see 
a patient in the hands of such a careless nurse, how- 
ever. 

Affection only, however warm, will not qualify a 
sick-nurse for her position. The cool head and steady 
hand of a professional stranger is often to be pre- 
ferred. Many a life has been sacrificed by ignorance, 
stupidity or anxiety of the affectionate nurse who un- 
doubtedly would have gladly died to save the patient. 

A good nurse should have keen perceptions and 
the nice ways of a lady, and at the same time she 
should not be above supplying all the patient's needs. 
She should never talk of the dying agonies of her last 
case, or relate any of her previous cases whatever they 
might have been. She should be able to judge when 
the patient must be kept quiet and when he may see 
a friend. Such a person, without giving offense, must 
assume the responsibility of forbidding the discus- 
sion of worrying, household troubles in the sick- 
room, or even getting rid of a visitor who stayed 
too long — especially of that class of persons who seem 
unwilling to lose a single opportunity of displaying 
bad taste and insensibility by telling the patient 
how some one else with the same symptoms had re- 
cently died in extreme convulsions. The lugubrious 
countenance assumed by such a visitor to har- 
monize with her conceptions of importance, usually 
confirms the fears of the sick person to a re- 
markable degree, and the nurse has increased labor 
in quieting the apprehensions thus cruelly excited. 

(S3P Insure Jn The Mutual Life Insurance Co. o? New York.) 



NURSES. 139 

Conversations upon any subject should never be held 

just outside the chamber door, where a word now and 

then can be overheard by those in the room; and, as 

intimated, what is overheard, with what is suspected, by 

the poor patient, is frequently the beginning of the 

worst. Remember always that a cheerful face "doeth 

good like a medicine." 

Never, under any circumstances, ask within hearing 

whether the physician does not think the patient worse, h h .. 

or ask the physician his opinion as to the result of the a t> ut the 

disease. Indeed, no question or reply calculated in patient in 

any way to suggest an unfavorable issue, should, under nis presence. 

any pretext, be indulged in before the patient. There 

is a good deal of human nature even in sick people. 

A trained nurse commences her arrangements for 

Make all 
the night before the patient begins to grow sleepy. 

She knows that arranging the pillows, moving the me nts for 

chairs, stirring the fire, and making up her own bed the night 

disturb the rest of the sick person. Sometimes an earl y- 

amateur does not think of this, and is surprised because 

the patient lies awake all night. A good nurse will 

also see in advance that nothing from down-stairs, 

likely to be needed before morning, has been omitted. 

It is the experience of most nurses that, when a 

. . 1 1 • , • 1 1- Do not read 

person is too sick to read, he is too sick to listen to much to a 

the reading of any one else. If you do read, let it be patient. 

done slowly, distinctly and steadily. Sick people 

almost always prefer having a thing told to having it 

read to them. 

The eyes of the convalescent and debilitated are 

easily injured by use. The greatest care should be Do not let a 

taken, therefore, to use them as little as possible be- P atlent read 

fore recovery. Quite aside from the patient's strength, muc ' 

the usual absence of the necessary amount of light for 

(f^ Insure in The Mutoal Life Insurance Co o? Kew Yokk 



140 



NURSES. 



Make some 
variety in 
the sick 
room. 



Plants and 
flowers may 
be allowed. 



reading purposes makes reading in a sick-room al- 
most as dangerous to the sight as the use of print in 
the growing twilight — well known to be peculiarly 
destructive to the vision. 

No one but an old nurse, or a person who has been 
ill for a long time, can possibly know what a weary, 
dreary thing it is to be confined to the same room for 
a great while, and see no change in anything about it. 
It will be found that the majority of cheerful patients 
are those who are not confined to a single room, and 
the majority of depressed cases will be seen among 
those subjected to a long monotony of objects sur- 
rounding them. The nervous system really appears 
to suffer as much from want of change as the digestive 
organs would from continuance upon a single diet — 
i. e., the soldier from his "three years or during the 
war," of boiled beef. Unless a person has been 
sick, and has learned from personal experience, 
he can scarcely realize what a pleasant thing 
it is to see beautiful objects and brilliant colors 
while recovering from illness. Such cravings are 
termed "fancies" by some; but no matter what 
they are called, these indications are always valuable 
and should never be disregarded. The senses of sight 
and hearing require natural and innocent gratification 
as much as the stomach demands appropriate food. It 
is a helpful satisfaction to indulge them, and it should 
be done. If the indulgence makes the sick person get 
well the faster, a wise nurse will observe these 
"fancies," and make them assist convalescence. 

It is a popular prejudice that plants and flowers 
should not be tolerated in the chamber, "because they 
give off carbonic acid gas, which is poisonous." So 
they do give off this gas, and the gas is poisonous; 



flgy" InBure in The Mutual Life Insubance Co. op New Yoke.) 



NURSES. 141 

but the quantity of carbonic acid gas given off from 
half a dozen bunches of flowers in half a dozen nights 
would scarcely equal the amount of the same gas given 
off from a couple of bottles of mineral water. The 
odor of certain flowers, as lilies, hyacinths, etc., 
is unpleasant to some people, and whenever such is 
the case, the objectionable ones should, of course, be 
avoided in the selection. A judicious variety in the 
colors should always be sought, and it may be well to 
remember that scarlet is rather stimulating in its ef- 
fects, while blue is rather soothing. 

In convalescence, even more than in illness, the 
attentions of an inexperienced nurse are often trying 
to an invalid. If he has been well nursed, he may still covales . 
be amenable to the discipline of the sick-room, and cence. 
will probably do what he is bid. If he has not learned 
to do as told without question, he has still many things 
to learn before he gets well. At first, perhaps, he 
will be allowed to sit up hours, when minutes was the 
physician's orders. He is able to persuade the nurse 
to give him a tumblerful w r hen a wineglass was al- 
lowed. He is allowed to see a newspaper for a few 
minutes, and he reads an exciting novel. He is per- 
mitted to see a visitor, and has a roomful of company. 
He leaves the house for the first walk, muffled up, and 
is allowed to sit on a cold garden seat. Upon. return- 
ing home exhausted, there is no nourishment ready for 
him, and probably the warmed clothing is taken off 
to put on his cold house suit. 

FOOD. 

A little food at a time and often repeated, is the 
general rule for sick people. Frequently, where a 

(jgrlnsure in Thb Mutual Lips Insurance Co. op New York.) 



142 



FOOD. 



A little food 
at a time. 



A little food 
early in the 
morning. 



Dangers of 
alcoholics, 



physician orders beef-tea, or something of the kind, a 
nurse will try to give a cupful every three or four 
hours. More than likely the patient's stomach rejects 
it, whereas, had a tablespoonful been given every half 
hour or so, it would have been retained, digested and 
have done the patient the intended good. 

The majority of weak patients are unable to take 
food of any solid kind before eleven o'clock in the 
morning, and before that time comes around they are 
sure to be pretty well exhausted. This would not be 
so apt to occur if a spoonful of beef-tea, of wine and 
arrow-root, of whisky-punch, or of whatever stimu- 
lant has been ordered by the physician, could be given 
them every hour or two, from the early morn until 
then. Perhaps by noon, or even sooner, they might be 
able to eat food as substantial as a mutton-chop or a 
piece of nicely broiled beefsteak. If food as solid as 
these cannot be taken, of course the nurse will perse- 
vere in the use of beef-tea, prepared milk, or whatever 
else the physician has ordered. 

In this connection, it mav be well to make a few 
remarks about the use of brandy, whisky and other 
stimulants for the sick. They are always easily obtain- 
able, and therefore, oftenest used. But where there is 
any hereditary tendency to the use of such things, 
where the individual has ever shown a disposition to 
use them as a beverage, or where the associations 
of the person in the future may peculiarly expose him 
to solicitation, none of these stimulants, under any 
consideration, should ever be ordered, unless there is 
absolutely no alternative. This is said, because in 
many instances substitutes can easily be found by the 
physician. 

(jt3p*Insure in Thk Mutual Life Insubanok Co, of Nbw York.) 



FOOD. 143 

The susceptibility of the very young to all forms 
of alcoholic stimulants must also be remembered. Suscepti- 
Where we would give a tablespoonful of whisky or bility of the 
brandy every three or four hours to an adult a child young to 
of two would get ten drops every hour or two, a alcoholics, 
child of five a teaspoonful every two or three hours. 
If we are not careful, we are very apt to overstimulate 
a child. 

Never leave the patient's food untasted by his side 
from meal to meal, in the hope that he will eat it. 
He never does eat it, and you only add disgust to a pat i ent ' s 
his distaste, by leaving it in sight. Let the food be f 00 d by his 
brought at the right time, and if it is not eaten, be side 
sure to take it away in a little while. untasted. 

A sick person's plate should never be overloaded 
with food, nor should he ever see or smell the food Do not 
prepared for others. While eating, the patient should overload the 
be left alone as much as possible. p ate# 

Whatever is prepared for the sick must always be 
of the first quality, and cooked with the greatest care. The best of 
Remember that sick-cookery should at least do half food and 
the work of the patient's weak digestion. 

Always keep your patient's cup and saucer per- 
fectly dry, so that no drops of liquid will fall on the Kee P the CU P 
sheets, pillow or dress. As a rule, nurses have no idea and saucer 
what a difference this minute want of care makes 
to the comfort and even willingness of the sick to take 
food. 

Florence Nightingale says on this subject that one 
of the most common errors among women in charge Be f . 
of the sick, respecting sick diet, is the belief that beef- f uttle 
tea is the most nutritive of all articles. "Now just try," value, 
she says, "and boil down a pound of beef into beef-tea, 
evaporate the water, and see what is left of your beef. 

(tp" Insure in Thb Mutual Lifb Insurance Co. of Nsw York.; 



144 



FOOD. 



Do not 
overrate the 
value of 
eggs. 



Meat alone 
may produce 
scurvy. 



Animals 

require 

albumin 



You will find that there is barely a teaspoonful of 
solid nourishment to half a pint of water in beef-tea." 
There is, nevertheless, a certain nutritive value in 
it, as there is in tea. It may safely be given in almost 
any inflammatory disease, but it should never be alone 
depended upon, especially where much nourishment 
is needed. 

Again, it is an ever-ready saying that "an egg is 
equivalent to a pound of meat," whereas it is not so at 
all. Much trouble has occurred from this mistaken 
notion. It is a question whether, weight for weight, 
eggs are equal to beefsteak. Also, it is seldom noticed 
with how many patients, particularly those of nervous 
or bilious temperament, eggs disagree. Most pud- 
dings made with eggs are distasteful to them in con- 
sequence. An egg, whipped up with wine, is often the 
only form in which they can take this kind of nourish- 
ment. 

Again, if the patient is able to eat meat, it is sup- 
posed that to give him meat is the only thing needful 
for his recovery ; whereas scorbutic (scurvy) sores have 
been known to appear among sick persons living 
in the midst of plenty, which could be traced to no 
other source than this — namely, that the nurse, de- 
pending on meat alone, had allowed the patient to be 
without vegetables for a considerable time, these latter 
being so badly cooked that he always left them un- 
touched. To all intents and purposes, he really had no 
fresh vegetables at all. 

Animals require in their food an albuminous con- 
stituent, a starchy one, and another of fat. The first, 
or albuminous (the purest form of which is the white 
of an egg), enters largely into the formation of the 
human body, the muscles being chiefly composed of it. 

(!Gg~Insure in The Mutual Life Insurance Co. op New York.) 



FOOD. 



145 



The second, or starchy component, does not enter 
into the structure of the body as such, but is converted starch 
into sugar during digestion, and has much to do with 
the formation of the tissues and heat. 

The oily parts enter largely into the composition of 
the brain, nerves, and, in fact, all other portions of the 
body, and, when broken up and consumed, supply a at ' 
good portion of the fuel for heat of the body. 

Besides these three mentioned, which are most con- 
spicuous, there are other substances, as common salt, 
phosphates, iron, etc. These are supplied through and salts, 
food, but our space will not permit more than a mere 
reference. All food must contain these substances in 
proportionate quantities. If it does not, the appetite 
craves the one missing, and if not properly supplied, 
the part of the body which needs the deficient com- 
ponent suffers. 

To feel assured of this, if the reader thinks a mo- 
ment, he will remember that no one likes bread alone, All should 
but wants with it some butter, which supplies the oily . be P resent 
part, and the appetite craves, too, a piece of meat, 
cheese, or an egg — the albuminous part. We want 
butter with our rice or potatoes, because rice or potato 
is almost pure starch, and wanting in fatty matter ; so 
nature says we must add the wanting parts. 

As all food which properly sustains man must con- 
tain these principles, it will be readily seen that those Life cannot 
vegetable substances which are composed of but one be sustained 

of them, or even two, cannot alone support life. Ex- 

' ' m rir even two. 

perience confirms this view. Oils or fat are useful as 
oils or fat, but cannot supply the place of starch or 
sugar; nor can starch or sugar supply the place of 
albumen or flesh. 



(^"Insure in The Mutual Life Insurance Co, o» New York.) 



146 



FOOD. 



Great value 
of milk. 



Value of 
flour and 
cereals. 



Value of 
starches. 



To obtain all these needful constituents, we must 
seek a variety in our food, and not depend exclusively 
upon any single one for continued use. There are 
some apparent exceptions to this rule, as in the case 
of milk, which we know is capable, under certain cir- 
cumstances, of sustaining life for a length of time ; but 
when we examine into the matter the exception is only 
apparent, for milk contains all of the constituents 
necessary for perfect food. It has the starchy part ad- 
vanced a step into the shape of sugar, the albuminous 
part as the cheesy constituent, and the fatty as the 
creamy element. Hence milk can be taken as a sort 
of representative diet, and one better adapted to sus- 
tain the body in health, or to strengthen it in sickness, 
than any single article of food. 

Flour made from wheat, meal from oats or Indian 
corn, grits, etc., come next in order, perhaps, and stand 
at the head of the list of all articles of food grown for 
general consumption. Food of the above description 
is made up chiefly of starch, some albumen (under the 
form of gluten), and a certain amount of oil. Flence, 
bread made of flour may well be called the "staff of 
life," because, from containing these elements, it is 
capable of supporting life by itself, for a longer time 
than any other single article of food, excepting milk, 
as mentioned above. But, though containing these 
essential elements of life, yet flour, without the addi- 
tion of albuminous or oily matter, to a certain degree, 
cannot long properly sustain the human body. 

If flour cannot nourish the body in a proper manner, 
it will at once be seen that corn-starch, arrow-root, 
tapioca, and the like — which are nothing but pure 
forms of starch, made by washing away the oily and 
glutinous (albuminous) parts — cannot possibly be ex- 



&^" Insure }q Ths Mutual Lifk Insubancb Co. op Njjw Tokk.) 



FOOD. 147 

pected, when used alone, to afford more than a limited 
amount of nourishment; not, of course, as much as 
food prepared from flour, which has in it the deficient 
articles. Not only is flour more nutritive than arrow- 
root, or any preparation of starch, but it is less liable 
to ferment, and, as a rule, it should be preferred when- 
ever it can be used. 

Do not misunderstand what is meant. None of 
these articles, compared with flour, are spoken of as 
useless to the body ; but some preparations for the sick 
must be more useful than others, because they contain 
more of the elements of usefulness in the shape of 
albumen, starch, oil, etc. 

But if fresh milk is so valuable a food for the sick, 
the least sourness in it makes it, of all articles, per- 

, ,, ... -,-.. . . Milk should 

haps, the most injurious. Diarrhoea is a common , 

. be very 

result of fresh milk allowed to become at all sour. The f res h. 
nurse, therefore, ought to exercise the utmost care in 
this particular. Yet if you consider that the only drop 
of real nourishment in your patient's tea is the drop 
of milk, and how much all patients depend upon their 
tea, you will see the great importance of not depriving 
your patient of this milk. 

The desire shown by the sick, and especially by 
those who are getting well, for acid fruits, as oranges, Acid fruits 
baked apples, cranberries, lemons, etc., should never are often 
be disregarded. The important use the acids of fruits S rateful - 
play in the body is a long story ; so we can only insist 
upon the importance of regarding these "cravings" 
wherever found. Sometimes the physician has good 
reasons for not wishing them given, as the acid may 
neutralize or decompose some remedial agent em- 
ployed, but as a rule these fruits, properly prepared, 
may not only be given v/ithout injury, but with de- 

(g3F* Insure ia Ths Mutual Lih Insurance Co. op New Yoek.) 



148 



FOOD. 



Jelly con- 
tains almost 
no nourish- 
ment. 



How to make 
beef-tea. 



cided benefit. So, whenever a sick person has a crav- 
ing for such things, be sure to call the physician's 
attention to it, and ask if you can give them. 

Calves-foot jelly is another article of diet in great 
favor with nurses and friends of the sick. Even if it 
could be eaten solid, it would not nourish. It is simply 
the height of folly to take one-eighth ounce of gela- 
tine and make it into a certain bulk by dissolving it in 
water, and then 'to give it to the sick, as if the mere 
bulk represented nourishment. It is not generally 
known that jelly does not nourish, that it has a ten- 
dency to produce diarrhoea, and to trust to it to repair 
the waste of a diseased constitution is simply to starve 
the sick under the guise of feeding them. If one 
hundred spoonfuls of jelly were given in the course 
of the day, you would have given one spoonful of 
gelatine, which spoonful has scarcely any nutritive 
power whatever. 

Dr. Christison says that "every one will be struck 
with the readiness with which certain classes of pa- 
tients will often take diluted meat-juice or beef-tea re- 
peatedly, when they refuse all other kinds of food." 
But beef-tea as ordinarily made is really only a stim- 
ulant, very much like coffee. To make a beef-tea that 
contains considerable nutriment, as well as stimulant, 
cut a thick piece of good, juicy steak into lumps about 
the size of a small lemon. Broil each piece slightly 
and then squeeze it thoroughly in an ordinary lemon- 
squeezer, or, better still, in one of the small meat- 
presses that are made nowadays for this purpose. You 
will not get a great deal of juice, but it is a fair nutri- 
ment for the sick. It can be served hot or cold, with 
salt and pepper to suit. 



(JSP" Insure in The Mutual Life Insurance Co. op New York.) 



FOOD. 149 

A great deal too much is said against tea* by wise 
people, and a great deal too much tea is given to V alue of 
the sick by foolish people. When, however, you see t ea and 
the natural and almost universal craving in the sick coffee, 
for their "tea," you cannot but feel that nature knows 
what she is about. 

But a little tea or coffee restores them quite as much 
as a great deal ; and a great deal of tea or coffee But do not 
impairs the little power of digestion they have. Yet give too 
a nurse, because she sees how one or two cups of much - 
tea or coffee restores her patient, often thinks that 
three or four cups will do twice as much. This 
is not the case at all ; it is, however, certain that there 
is nothing yet discovered which is a substitute to the 
patient for his cup of tea ; he can take it when he can 
take nothing else, and he often can take nothing else, 



* Persons about to incur great exhaustion, either from the 
nature of the service, or from their being not in a state fit for 
it, are frequently advised to eat a piece of bread. I wish the 
recommenders would themselves try the experiment of sub- 
stituting a piece of bread for a cup of tea or coffee, or beef-tea, 
as a refresher. They would find it a very poor comfort. When 
soldiers have set out fasting on a fatiguing duty, when nurses 
have to go fasting in to their patients, it is a hot restorative 
they want, and ought to have before they go, and not a cold bit 
of bread. If they can take a bit of bread with the cup of hot 
tea, so much the better, but not instead of it. The fact that 
there is more nourishment in bread than in almost anything 
else has probably induced the mistake. That it is a fatal mis- 
take there is no doubt. It seems, though very little is known 
on the subject, that what "assimilates" itself directly, and with 
the least trouble of digestion, with the human body, is the best 
under the above circumstances. Bread requires two or three 
processes of assimilation before it becomes like the human 
body. The almost universal testimony of men and women who 
have undergone great fatigue, such as riding long journeys 
without stopping, or sitting up several nights in succession, is 
that they could do it best upon an occasional cup of tea — 
and nothing else. 

Let experience, not theory, decide upon this as other 
things. 

(J^Tlnsnre in The Mcttal Life Inscran-ck Co. op New York.) 



150 FOOD— BEDDING. 

if he has not it. It would be very desirable to have the 
detractors of tea point out what to give to a patient 
after a sleepless night, instead of tea. 

If you give it at five or six in the morning, the 
patient may even sometimes fall asleep after it, and 
When to give ^ et ' P erna P s > his only two or three hours' sleep during 
tea or coffee. tne twenty-four. At the same time, you never should 
give tea or coffee to the sick, as a rule, after five 
o'clock in the afternoon. Sleeplessness in the early 
night is usually due to excitement, and is increased by 
tea or coffee ; sleeplessness which continues to the 
early morning is often from exhaustion, and is relieved 
by tea. 

BEDDING. 

In looking for an example of what not to do, we may 
take the specimen of an ordinary bed in a private 
house ; a wooden bedstead, two or even three mat- 
tresses piled up above the height of a table, with a 
valance attached to the frame. Nothing but a miracle 
could ever thoroughly dry or air such a bed and bed- 
ding. The patient must certainly alternate between 
cold damp after his bed is made, and warm damp be- 
fore, both saturated with organic matter,* and this 
from the time the mattresses are put under him until 
the time they are picked to pieces, if this is ever done. 

Consider that an adult in health exhales by the 



* For the same reason, after washing a patient, if you must 
put the same night-dress on him again, always give it a prelim- 
inary warming at the fire. The night-gown he has worn must 
be, to some extent, d&mp. It has now become cold from 
having been off him for a few minutes. The fire will dry and 
at the same time air it. This procedure is much more im- 
portant than with clean things. 

(J^* Insure in The Mutual Life Insurance Co. OP New York.} 



BEDDING. 151 

lungs and skin, in the twenty-four hours, one or two 
pints of moisture, loaded with organic matter ready sheets 
to enter into putrefaction ; that the quantity in sick- should be 
ness is often greatly increased, the quality is always cnan & ed 
more noxious — and ask yourself where does all this , aiyor 1 _ 1 

. J thoroughly 

moisture go? Chiefly into the bedding, because it a i re d. 
cannot go anywhere else. It stays there, because, with 
the exception of a weekly change of sheets, scarcely 
any other airing is attempted. A nurse will be careful 
to fidgetness about airing the clean sheets, because 
of their dampness, but airing the used sheets because 
of noxious damp will never occur to her. Besides this, 
very dangerous effluvia we know arise from the 
excreta of the sick. These are placed, at least tem- 
porarily, where they must throw their effluvia into the 
under side of the bed, and the space under the bed is 
never aired ; it cannot be with our arrangements. Must 
not such a bed be always saturated, and be always the 
means of introducing again into the body of the un- 
fortunate patient who lies in it that poisonous matter 
which nature is trying to get out of the system? 

If a bed is higher than a sofa, the patient often 
prefers not to get out at all, rather than undergo the Bed s hould 
fatigue of getting out. Were the bed a low one, he be low and 
might often feel like taking a few minutes' exercise near lhe 
every day in another room, or even in the open air. wlndow - 
It is very odd that people never think of this, or of 
how many more times a patient who is in bed for 
twenty-four hours is obliged to get in and out of bed, 
than are those who only get into bed and out of bed 
once during the twenty-four hours. 

A patient's bed should always be in the lightest 
spot in the room ; and he should be able to see out of 
a window. 

(J2?~ Insure in Thk Mutual Li?s Ixsuranck Co. of New York. ) . .-v:" 



*£si?fiP 



152 



BEDDING. 



Coverings 
should be 
light. 



How to 
arrange 
pillows. 



It is scarcely necessary to say that the old four-post 
bed with curtains is utterly inadmissible. Hospital 
bedsteads are in many respects very much better than 
private ones. 

Never use anything but light blankets as bed-cover- 
ing for the sick. The heavy cotton impervious coun- 
terpane is bad, for the very reason that it keeps in 
the emanations from the sick person, while the blanket 
allows them to pass through. Weak patients are in- 
variably distressed by a great weight of bed-clothes, 
which may prevent their getting any sound sleep 
whatever. 

One word about pillows. Every weak patient, be 
his illness what it mav, suffers more or less from diffi- 
culty in breathing. To take the weight off the poor 
chest, which at best is hardly up to its work, ought 
therefore to be the object of the nurse in arranging 
his pillows. Now, what does she usually do, and what 
are the consequences? She piles the pillows one 
upon the other like a wall of bricks ; the head is thrown 
upon the chest, and the shoulders are pushed forward, 
so as not to allow the lungs room to expand. The 
pillows, in fact, lean upon the patient, not the patient 
upon the pillows. It is impossible to give a rule 
for the arrangement of pillows, because it must 
vary with the figure of the patient. Tall patients 
suffer much more than short ones, because of the 
drag of the long limbs upon the waist. But the ob- 
ject is to support, with pillows, the back below the 
breathing apparatus, and above the hips ; so as to 
allow the shoulders room to fall back, and to support 
the head, without throwing it forward. The suffering 
of exhausted patients is greatly increased by neglect 
of these points. And many an invalid, too weak to 

({^"Insure in Thk Mutual Lifb Insurance Co. op New Yokk,) 



DRAINAGE. 153 

drag about his pillows himself, slips his book or 
anything at hand behind the lower part of his back to 
support it. 

DRAINAGE. 

This should be constructed so as to keep out of the 
air of the house any admixture of sewer-gas,but it often 
fails entirely, owing to incorrect or defective plumb- 
ing. The danger is not so much from the sewer-gas 
itself as it is from the germs of disease which may be 
present. These are not volatile, but are sprayed up 
into the air of the sewer by the breaking of bubbles on 
the surface. Their weight is so light that they are 
carried about by the air-currents. In order to pre- 
vent disease from this source, the house must be prop- 
erly plumbed. To do this, the soil-pipe should open 
on the roof, and every trap should be back-aired. The 
diagram on the following page shows these points. 

Besides the conditions enumerated which are ab- 
solutely essential, there are some others which it is 
well to bear in mind. The soil-pipe should be of iron 
and 4 inches in diameter. After it changes from the 
perpendicular it should have a slope of I in 30, so as 
to insure a current of at least 4J/2 feet per second. 
The traps should be the S-shaped siphon traps, pref- 
erably without pans or hoppers, but flushing directly. 
The water-closets should not communicate directly 
with the house-tank, but with small waste-preventer 
tanks, which are filled automatically from the house- 
tank. 



(^""Insure in The Mutual Life Insurance Co. op New York.) 



154 



DRAINAGE. 




A is the sewer. ABCif the soil-pipe, opening on the roof 
at C, and trapped at D. E F is the ventilating-pipe, communi- 
cating with the soil-pipe just behind D. G J K H is the venti- 
lating-pipe to the traps, opening on the roof at G and giving 
off branches at J K and N to the traps of the fixtures L M O, 
which branches are connected on the soil-pipe side of the traps 
as indicated. P R is the leader from the roof, connected with 
the soil-pipe at B and trapped at R. The object of E F is to 
have a constant current of air blowing through the pipe. The 
air in B C being within the house, becomes heated and escapes 
through C, while fresh air enters through E F. The object of 
G H and its branches J K N is to prevent siphoning of the 
traps by an action similar to that of a Sprengel air-pump. 



* (The engraver has made all the traps in the diagram too 
shallow except at R. They should be so deep as to divide the 
U-shaped column of water into two distinct limbs, connected 
only at the bottom.) 

d^*Inaure in The Mutual Life Insurance Co. of New Yoajc.) 



DRAINAGE. 



155 



It is impossible for sewer-gas to enter a house 
plumbed in this way. But oftentimes many of these 
precautions are neglected, and the results are quite 
graphically shown in this diagram: 




6ECTION 
•TREET 6EWER 



|Qp" Insure In Thk J'ptijal Lips Ixscraxcb Co. o» Kkw York. 



SECTION V. 



REMEDIES. 



Next in value to the prevention of disease or 
accident is indemnity for the possible results of both. 
The Mutual Life Insurance Company of New 
York, by its policies provides such indemnity. 



REMEDIES. 159 



REMEDIES. 

In this section we will discuss briefly the simple 
remedies, both internal and external, which it is ad- 
visable to have in the house. Even in a city, where a 
drug store is always near, one will find it convenient 
and comfortable to have something of a medicine- 
chest. In the country it is almost an essential. 

Nowadays most medicines can be obtained in the 
form of tablets, each containing a definite quantity of 
drug, and we strongly urge the use of these whenever 
possible. The dosage is accurate, and the medicine 
keeps almost indefinitely without change or deteriora- 
tion. 

When liquids must be used, it is advisable to keep 
them in bottles with ground-glass stoppers. Most 
liquids evaporate slowly through an ordinary cork, 
and the result varies according to the nature of the 
preparation. In some, such as aromatic spirits of am- 
monia, it becomes very weak, and even useless. In 
others, such as laudanum, it may become two or 
three times as strong. We can readily appreciate how 
harmful an unknown change in either direction might 
be. 

Powders should be kept in wide-mouthed bottles. 
They undergo changes less readily there than in boxes, 
either of wood or pasteboard. 

There should always be a label on the bottle, even 
if there is one on the stopper too. In that way con- 
fusing mistakes can be avoided. 

All the medicines should be kept in one box or 
closet, which should be securely locked. The key to 

(t&~ Insure in Th» Mutual Lifk Iksotuncb Co. op Kkw York.) 



160 INTERNAL REMEDIES. 

this should be put in some place where children can- 
not get it. In this way both destruction of property 
and risk of life will be avoided. 

We will divide remedies into two groups, internal 
and external, and will arrange them alphabetically in 
each. 

INTERNAL REMEDIES. 
ALCOHOL. 

This is of great value as a stimulant, and some form 
of it should be kept on hand. The best varieties for 
medicinal purposes are brandy, whisky and cham- 
pagne, but in an emergency any kind of liquor or 
wine may be used. Brandy and whisky contain about 
50 per cent, of alcohol, port and sherry about 18 to 
20, champagne about 15, red and white wines 8 to 12. 
The dose varies greatly according to the needs of 
the case. It should be borne in mind that children are 
rather susceptible to alcohol. Where a tablespoon- 
ful of whisky would be used in the case of an adult, 
we would give under similar circumstances to a child 
of two thirty drops ; to a child of six a teaspoonful. 

AMMONIA. 

This is an excellent stimulant and antacid. It is 
used in the form of aromatic spirits of ammonia. The 
dose of this is thirty drops to a teaspoonful in half a 
glass of water. It can be repeated as often as neces- 
sary. 

ATROPINE. 

"This is the active principle of belladonna, and is 
used in the form of sulphate of atropine. It is of great 

(B3T Insure in The Mutual Life Insurance Co. op New York ) 



INTERNAL REMEDIES. 161 

value in poisoning by mushrooms or opium. It can be 
obtained in tablets, and the dose is one one-hundredth 
of a grain, equivalent to ten drops of the tincture of 
belladonna. 

BELLADONNA. 

See " Atropine, " which is always to be used if we can 
get it. If not, the tincture of belladonna can be given 
in doses of ten drops. This can be obtained in tablet 
form. 

BISMUTH. 

This is used in the form of the subnitrate or sub- 
carbonate of bismuth. These are both white insoluble 
powders, and may be used interchangeably. Either 
of them is of great value in all forms of diarrhoea and 
dysentery. It can be given quite freely, an even tea- 
spoonful every two or three hours not being excessive. 

It is also used as a drying powder over wounds, and 
has the great merit of being absolutely non-poison- 
ous and bland. 

BLACKBERRY BRANDY. 

This is used in diarrhoea and dysentery as a stimu- 
lating astringent. The dose is a tablespoonfUl every 
two or three hours. 

BROMIDE. 

This is of great value in allaying nervousness and 
promoting sleep, and also in strychnine poisoning. 
Either the bromide of sodium or potassium can be 
used, preferably the former. The dose is ten to twenty 
grains It can be obtained in tablet form, but we 

(t3T Insure in Thb Mutual Life Insueancb Co. op New Yohx. 



162 INTERNAL REMEDIES. 

should be careful to dissolve the tablets before ad- 
ministering. 

CALOMEL 

The value of this as a purgative is too well known 
to be described here. Formerly it was given in too 
large doses. Three or four half-grain tablets will 
work just as well as ten grains in powder. 

CASTOR OIL. 

This is of great value as a preliminary purgative 
in all forms of diarrhoea and dysentery. The dose is 
one or two tablespoonfuls. The disagreeable flavor 
can be largely overcome by rinsing the mouth out 
thoroughly with a teaspoonful or two of raw brandy 
or whisky, both before and after taking the oil. 

IPECAC. 

This is a depressing emetic, and is of especial value 
in croup. It is so slow in its action that we prefer 
the sulphate of zinc in a case of poisoning. The dose 
of the powdered drug is fifteen grains, which can be 
repeated in twenty minutes. We generally give to 
children a teaspoonful of the syrup every twenty min- 
utes until vomiting is produced. 

LIME WATER. 

Put in a quart bottle a piece of freshly slacked lime 
as big as an English walnut. Fill the bottle with 
water and shake thoroughly. Let it stand, and in 
twenty-four hours we will have as good lime-water 
as can be made. It can be kept in the same bottle, care 

(I5f Insure in The Mutual Life Insurance Co. ot New York.) 



INTERNAL REMEDIES. 163 

being taken not to disturb the sediment. The bottle 
may be filled twice more with water, the same lime 
being used. After that the sediment should be cleaned 
out and fresh lime introduced. 

MUSTARD. 

This is a stimulating emetic. A teaspoonful can be 
stirred into a pint of water and a glassful of this given 
every fifteen minutes until vomiting is induced. 

OPIUM. 

The best preparation of this is the deodorized tincture, 
which has the same strength as the ordinary tincture, 
commonly called laudanum. The dose is five drops, 
repeated every two or three hours if necessary. It can 
be obtained in tablet form. Children are very sus- 
ceptible to opium, and for this reason we give them 
the very weak preparation known as paregoric, the 
proper name of which is the camphorated tincture of 
opium. The dose of this for a child of two is ten 
drops ; for one of three, thirty drops ; for one of five, 
a teaspoonful. Even in these doses it should be used 
with great caution. 

QUININE. 

The best preparation of this is the bisulphate. It 
can be obtained in tablet or pill form. 

SALTS-EPSOM AND GLAUBER'S. 

The former is sulphate of magnesium, and is quite 
bitter. The latter is sulphate of sodium, and is much 
pleasanter to take. They are both purgatives, in doses 
of two to four teaspoonfuls dissolved in a glass of 
water. 



("^"Insure In Thk Mutual Lifb Insurance Co. ov New Tobk.) 



164 EXTERNAL REMEDIES. 

SULPHATE OF ZINC. 

This is a very prompt emetic, and of great use in case 
of poisoning. The dose is twenty grains, which can 
be repeated every fifteen minutes until vomiting is 
produced. Three or four powders of this size should 
always be kept on hand. 

EXTERNAL REMEDIES. 
BICHLORIDE OF MERCURY. 

This is commonly called "corrosive sublimate." It 
is of great value as an antiseptic and disinfectant. It 
is now very conveniently put up in tablet form. If 
each tablet contains 7 3-10 grains, this can be dissolved 
in a pint of water, making a solution of the strength 
of 1 to 1,000. If a quart of water is used, the strength 
of course will be 1 to 2,000. These solutions should 
not be put in metal dishes, as the mercury will leave 
the water and unite with the metal. As corrosive 
sublimate is a very deadly poison, all precaution must 
be used to prevent its being taken internally. 

BORIC ACID. 

This is not at all like an ordinary acid, but is a white 
powder, which dissolves easily in water. It is much 
used as a non-irritating, mild antiseptic. It is not 
strong enough for all purposes, but is of much value, 
as it is practically non-poisonous. A heaping tea- 
spoonful, dissolved in a glass of warm water, will 
make a solution of the strength of 4 to 100. It is a 
very efficient dry antiseptic when mixed with bismuth 
subnitrate or subcarbonate. Three teaspoonfuls of 
bismuth with one of boric acid make a very serviceable 
drying powder. 

(JCST'Insure in The Mutual Life Insurance Co. op New Yobk.) 



EXTERNAL REMEDIES. 165 

CARBOLIC ACID. 

This is an efficient antiseptic, but poisonous, and also 
<rery irritating unless well diluted. It should never be 
used stronger than i in 30. This can be made by mix- 
ing one tablespoonful with a pint of water. It takes a 
little time and shaking for the mixture to be complete. 

COLLODION, 

This is a solution of gun-cotton in alcohol and 
ether, with a little castor-oil added to make the mix- 
ture flexible. It is a very nice covering for small cuts, 
much better in every way than plaster. It is a liquid 
which is quickly applied by means of a small brush or 
swab to the dried surface. The alcohol and ether 
evaporate in a few seconds, leaving a firm flexible 
film closely applied to the parts. This is not affected 
by water. 

MUSTARD PLASTER. 

This is an excellent counter-irritant, and is of great 
value in many conditions. It is usually made too 
strong. One part of mustard to ten parts of flour is 
quite strong enough. This can be well mixed with 
enough cool water to make a moderately thick paste. 
The size should be liberal, care being taken that the 
paste is separated from the skin by one layer of 
muslin or linen. It can be kept on for three or four 
hours usually. After it is removed, the skin should 
be carefully dried and smeared with vaseline or some 
ointment. If an immediate effect is wanted, the paste 
should be made of equal parts of mustard and flour. 
This, however, cannot be endured longer than a few 
minutes, and its action is frequently not as deep or 
far-reaching as that of the milder paste. 

C^" Insure in The Mctuai Lifb Instteanxk Co. op New Y9ES-. 



INDEX. 



Accident in general, 9; treatment, 10. 

Acetic acid, see Acids. 

Acids, burns by, 29; poisoning by, 90. 

Aconite, poisoning by, 100. 

Alcohol, poisoning by, 101; as a remedy, 160. 

Alcoholic beverages, dangers of, 142; in the young, 143. 

Ammonia, poisoning by, 90; as a remedy, 160. 

Aromatic spirits of ammonia, 160. 

Antimony, poisoning by, 91. 

Aquafortis, see Nitric Acid. 

Arsenic, poisoning by, 92. 

Artificial respiration, Marshall Hall's method, 18; Sylvester's 
method, 16. 

Asphyxia, 14; varieties, 15; by drowning, 15; by hanging, 19; 
by suffocation, 20; by carbonic acid gas, 20; by burning 
charcoal, 23; by coal gas, 23; by illuminating gas, 24; by 
foul air, 24; by foreign bodies in the throat ; 25. 

Atropine, poisoning by, 102; as a remedy, 160. 

Baryta, poisoning by, 94. 

Bathing the sick, 133. 

Bedding, 150. 

Beef-tea, value, of, 143; how made, 148. 

Belladonna, poisoning by, 102; as a remedy, 161. 

Bichloride of mercury, poisoning by, 96; as a remedy, 164. 

Bismuth, 161. 

Bites, 45; of dogs, 45; treatment of bite of rabid dog, 46. 

Blackberry brandy, 161. 

Bleeding from nose, 60; from wounds, see Hemorrhage. 

Blood-spitting, 60. 

Boric acid, 164. 

Brandy, 160; blackberry, 161. 

Bruises, 30; treatment, 31. 

Bromide, 161. 

Bryony, poisoning by, 103. 

Burns, 26; treatment, 27; by lime, caustic potash and other 
alkalies, 28; by acids, 29. 

Calomel, 162. 



168 INDEX. 

Camphor, poisoning by, 103. 

Carbolic acid, as a disinfectant, 128; as a poison, 103; as a 

remedy, 165. 
Carbonic-acid gas, suffocation by, 20; precautions against, 21; 

treatment when suffocated by, 22. 
Carbonic oxide, 23. 
Castor oil, 162. 
Chamber utensils, 126. 
Champagne, 160. 

Charcoal, suffocation from burning, 23. 
Chilblain, 68. 
Chloride of lime, 128. 
Chloride of zinc, 128. 
Chlorinated soda, 128. 
Cholera morbus, 74; epidemic, 75. 
Cleanliness, 132. 
Coal gas, suffocation by, 24. 
Coffee, value of, 149. 
Cold, influence on the death rate, 121; how to avoid catching, 

122 et seq. 
Collodion, 165. 
Conjunctivitis, 58. 
Contusions, 29; treatment, 31. 
Convalescence, risks during, 141. 
Convulsions in children, 55; epileptic, 69. 
Copper, poisoning by, 94. 

Corrosive sublimate, see Bichloride of Mercury. 
Cramps, when swimming, 18. 
Croup, 54. 

Diarrhoea, 72; treatment, 73. 
Digitalis, poisoning by, 104, 
Disinfectants, 127 et seq. 
Disinfection of excreta, 129; of the expectoration, 129; of the 

clothing and bedding, 130; of the person, 130; of the dead, 

130; of the sick-room, 131. 
Dislocations, 33. 
Drainage, 153 et seq. 
Drowning, 15; treatment, 15 et seq. 
Dulcamara, poisoning by, 104. 
Dysentery, 74. 
Ear, foreign bodies in, 58. 



INDEX. 169 

Earache, 53. 

Eggs, value of, 144. 

Emetics, in poisoning, 83. 

Epileptic convulsions, 69. 

Epsom salts, 163. 

Eye, foreign bodies in, 56. 

Faceache, 54. 

Fainting, 14. 

Fish, poisonous, 89. 

Flour, value of, 146. 

Flowers in sick-room, 140. 

Food, 141 et seq.; requisites of, 144-145. 

Foreign bodies in the ear, 58; eye, 56; nostrils, 58; ihroat, 25. 

Foul air in drains and privies, suffocation by, 24. 

Foxglove, poisoning by, 104. 

Fractures, 32; treatment, 33. 

Freezing, general, 67. 

Frost-bite, 66; treatment, 68. 

Fruits, value of as food, 147. 

Gas, suffocation by illuminating, 24. 

Glauber's salts, 163. 

Hanging, 19; treatment, 20. 

Heat, influence of on the death-rate, 122. 

Hemorrhage, from wounds, varieties, 355 treatment, 37. 

Henbane, poisoning by, 104. 

Hydrochloric acid, see Acids. 

Hyoscyamus, poisoning by, 104. 

Indian tobacco, poisoning by, 105. 

Insects in the ear, 59. 

Iodine, poisoning by, 95. 

Ipecac as an emetic for poisons, 85; as a remedy, 162: 

Iron, poisoning by, 95. 

Jelly, value of as food, 148. 

Jimson weed, poisoning by, 112. 

Labarraque's Solution, 128. 

Laudanum, 163. 

Lead, poisoning by, 95. 

Light, 134 et seq. 

Lightning, accidents from, 25. 

Lime in the eye, 58; burns by, 29; poisoning by, 96. 

Lime, chloride of, 128. 



170 INDEX. 

Lime-water, 162. 

Lobelia, poisoning by, 105. 

Lunar caustic,, poisoning by, 98. 

Malaria, 76; treatment, 77; preventive measures, 78. 

Marshall Hall's method of artificial respiration, 18. 

Meats, poisonous, 88. 

Mercury, poisoning by, 96. 

Milk, value of as a food, 146. 

Morphine, poisoning by, 105. 

Muriatic acid, see Acids. 

Mushrooms, poisoning by, 87. 

Mustard as an emetic, 83-163. 

Mustard plaster, 165. 

Nitric acid, see Acids. 

Nose, bleeding from, 60. 

Nurses, 137. 

Nux vomica, poisoning by, 112. 

Oil of vitriol, see Sulphuric Acid. 

Opium, poisoning by, 105; as a remedy, 163. 

Oxalic acid, poisoning by, 109. 

Oxalate of potash, poisoning by, no. 

Paregoric, 163. 

Phosphorus, poisoning by, 97. 

Pink-eye, 58. 

Pillows, how arranged, 152. 

Plants in sick-room, 140. 

Poisons, definition of, 81; treatment of poisoning in geaeral, 

82; emetics for, 83. 
Poison-vine eruption, 61. 
Potash, poisoning by, 97. 
Pulsatilla, poisoning by, no. 
Quinine, 163. 
Rabid dog, bite of, 46. 
Rabies in the dog, 48. 
Red precipitate, poisoning by, 96. 

Remedies, 157; internal, 160 et seq.; external, 164 et seq. 
Removing an injured person, 10. 
Respiration, artificial, Sylvester's method, 16; Marshall Hall's 

method, 18. 
Rest, 136. 
Salt as an emetic, 84. 



INDEX. 171 

Salts of lemon or sorrel, no. 

Sanguinaria, poisoning by, no. 

Savine, poisoning by, ill. 

Scalds, 28. 

Shock, 11; causes, 12; treatment, 13. 

Silver, poisoning by, 98. 

Soda, poisoning by, 98. 

Spanish windlass, aid in checking hemorrhage from wounds, 
39- 

Spigelia, poisoning by, ill. 

Spitting of blood, 60. 

Sprains, 34. 

Starches, value of as food, 146. 

Stomach-pump, 83. 

Stramonium, poisoning by, 112. 

Strychnia, poisoning by, 112. 

Suffocation, 20; by carbonic acid gas, 21; by fumes of char- 
coal, 23; by coal gas, 24; by illuminating gas, 24; by foul 
air, 24; by foreign bodies in the throat, 25. 

Sulphate of zinc, as an emetic, 85-164. 

Sulphuretted hydrogen, suffocation by, 24. 

Sulphuric acid, see Acids. 

Sunstroke, 61; treatment, 63; preventive measures, 64. 

Sylvester's method of artificial respiration, 16. 

Tea, value of, 149. 

Temperature of rooms, 125. 

Thorn apple, poisoning by, 112. 

Tin, poisoning by, 99. 

Tobacco, poisoning by, 113. 

Toothache, 54. 

Trained nurses, 138. 

Vegetable poisons, 99. 

Ventilation, 117 et seq. 

Vitriol, oil of, see Sulphuric Acid. 

Vomiting, measures to check, 76. 

Water as an emetic, 84. 

Whiskey, 160. 

Wounds, 34; varieties, 34; symptoms, 35; treatment of 

hemorrhage from, zj et seq.; cleansing of, 41; dressing 

of, 42; healing of, 42. 

Zinc, poisoning by, 99; sulphate of, as an emetic, 85-164; 
chloride of, 128. 



